The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy
Open accessAbstract
Objectives We sought to assess the impact of intermittent atrial fibrillation (AF) on health-related quality of life (QoL).Background Intermittent AF is a common condition with little data on health-related QoL questionnaires to guide investigational therapies.Methods Outpatients from four centers, with documented AF (n = 152), completed validated QoL questionnaires (Medical Outcomes Study Short Form 36 [SF-36], Specific Activity, Symptom Checklist, Illness Intrusiveness and University of Toronto AF Severity Scales). Comparison groups were made up of healthy individuals (n = 47) and four cardiac control groups: published (n = 78) and created for study (n = 69) percutaneous transluminal coronary angioplasty (PTCA); published heart failure (n = 216) and published postmyocardial infarction (MI) (n = 107).Results Across all domains of the SF-36, AF patients reported substantially worse QoL than healthy controls (1.3 to 2.0 standard deviation units), with scores of 24%, 23%, 16% and 30% lower than healthy individuals on measures of physical and social functioning, mental and general health, respectively (all p < 0.001). Patients with AF were either significantly worse (p < 0.05, published controls) or as impaired (study controls) as either PTCA or post-MI patients on all domains of the SF-36 and the same as heart failure controls on SF-36 psychological subscales. Patients with AF were as impaired or worse than study PTCA controls on measures of illness intrusiveness, activity limitations and symptoms. Associations between objective disease indexes and subjective QoL measures had poor correlations and accounted for <6% of the total variability in QoL scores.Conclusions Quality of life is as impaired in patients with intermittent AF as in patients with significant structural heart disease. Patients' perception of QoL is not dependent on the objective measures of disease severity that are usually employed.
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Patients with AF have significantly poorer quality of life than healthy controls.
“Patients with AF have significantly poorer quality of life than healthy controls, experiencing a variety of symptoms including lethargy, palpitations, dyspnoea, chest tightness, sleeping difficulties, and psychosocial distress.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [177]
Patients with AF experience symptoms including lethargy, palpitations, dyspnoea, chest tightness, sleeping difficulties, and psychosocial distress.
“Patients with AF have significantly poorer quality of life than healthy controls, experiencing a variety of symptoms including lethargy, palpitations, dyspnoea, chest tightness, sleeping difficulties, and psychosocial distress.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [177]
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- Authors
- Dorian, P., Jung, W., Newman, D., Paquette, M., Wood, K., Ayers, G. M., Camm, J., Akhtar, M., & Luderitz, B.
- Affiliations
- St. Michael's Hospital (CA)
- University Hospital Bonn (DE)
- Medtronic (United States) (US)
- St. Luke's Hospital (US)
- Corresponding author
- Newman, David
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2000-10
- Volume
- 36
- Issue
- 4
- Pages
- 1303-1309
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1969667526
- Cited by
- 627
- References
- 26
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 19 · 2023: 17 · 2022: 16 · 2021: 34 · 2020: 38 · 2019: 36 · 2018: 23 · 2017: 32 · 2016: 32 · 2015: 23 · 2014: 29 · 2013: 43 · 2012: 37
- FWCI
- 9.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- intermittent atrial fibrillation, health-related quality of life, SF-36, illness intrusiveness, disease severity, percutaneous transluminal coronary angioplasty, heart failure, post-myocardial infarction, activity limitation, symptom burden
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Electric Countershock, Female, Health Status Indicators, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Severity of Illness Index
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