Impact of rate versus rhythm control on quality of life in patients with persistent atrial fibrillationResults from a prospective randomized study
Abstract
Aims Despite the high prevalence of atrial fibrillation (AF), there are only limited data on quality of life (QoL) stemming from prospective trials comparing rate versus rhythm control. This prospective study evaluated QoL in patients with symptomatic persistent AF randomized to therapy aiming at rate versus rhythm control. Methods and results Patients with symptomatic persistent AF (7 to 360 days duration) were prospectively randomized to ventricular rate control (n=125) or to cardioversion and maintenance of sinus rhythm (n=127). QoL was assessed by the Medical Outcomes Study Short Form health survey (SF-36) at baseline and during 1 year of follow-up. Changes in QoL were compared on an intent-to-treat basis, and subsequently between patients in sinus rhythm versus AF. At baseline, all SF-36 scales were reduced compared to healthy controls. At 1 year, six of eight items had improved significantly in patients assigned to rate control, and five of eight items on rhythm control (p=ns). The physical component summary showed a comparable increase with both treatment strategies (rate control: p=0.004; rhythm control: p Conclusion In patients with symptomatic persistent AF, the two treatment strategies of rate versus rhythm control are associated with similar improvements in QoL.
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Improved quality of life has been noted with both pharmacological and interventional therapies.
“Improved quality of life has been noted with both pharmacological and interventional therapies, [181][182][183][184][185] but there are limited data to compare the benefit of different treatments.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [181]
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- Authors
- GRONEFELD, G.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-08
- Volume
- 24
- Issue
- 15
- Pages
- 1430-1436
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W2129290969
- Cited by
- 184
- References
- 25
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 12 · 2015: 6 · 2014: 19 · 2013: 8 · 2012: 10
- FWCI
- 9.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- persistent atrial fibrillation, quality of life, rate control, rhythm control, cardioversion, sinus rhythm maintenance, SF-36, physical and mental health, health-related quality of life
- MeSH terms
- Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Electric Countershock, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Electrocardiography, Ambulatory, Treatment Outcome, Patient Satisfaction
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