Development and validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in patients with atrial fibrillation
Abstract
BACKGROUND: Atrial fibrillation (AF) has a deleterious impact on health-related quality-of-life (HRQoL), but measuring this outcome is difficult. A comprehensive, validated, disease-specific questionnaire to measure the spectrum of QoL domains affected by AF and its treatment is not available. We developed and validated a 20-item questionnaire, Atrial Fibrillation Effect on QualiTy-of-life (AFEQT), in a 6-center, prospective, observational study. METHODS AND RESULTS: Factor analyses established 4 conceptual domains (Symptoms, Daily Activities, Treatment Concern, and Treatment Satisfaction) from which individual domain and global scores were calculated. Participants from 6 centers completed the AFEQT at baseline, at month 1, and at month 3. Psychometric analyses included internal consistency and known-group validity. Test-retest reliability was assessed by comparing 1-month changes in scores among those with no change in therapy. Effect size was used to assess responsiveness after intervention. Among 219 patients age 62±11.9 years, 94% completed the AFEQT at baseline and 3 months; 66% had paroxysmal, 24% persistent, 5% longstanding persistent, and 5% permanent AF. Internal consistency was >0.88 for all scales. Lower AFEQT scores were observed with increased AF severity, categorized as asymptomatic, mild, moderate and severe, respectively: 71.2±20.6, 71.3±19.2, 57.9±19.0, and 42.0±21.2. Intraclass correlations for Overall, Symptoms, Daily Activities, Treatment Concern, and Satisfaction scores were 0.8, 0.5, 0.8, 0.7, and 0.7, respectively. Changes in 3-month scores were larger after ablation than with pharmacological adjustments, and both were greater than those observed in stable patients. CONCLUSIONS: This initial validation of AFEQT supports its use as an outcome in studies and a means to clinically follow patients with AF.
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Assessment of quality of life is constrained by a lack of cross-validation of the several AF-specific quality-of-life tools.
“Assessment of quality of life is further constrained by a lack of cross-validation of the several AF-specific quality-of-life tools.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [188]
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“The strengths of the AFEQT include its validation and development as a measure specific to AF [34,51].”
BackgroundMethodScheuermeyer, F. X., Mackay, M., Christenson, J., Grafstein, E., Pourvali, R., Heslop, C., MacPhee, J., Ward, J., Heilbron, B., McGrath, L., et al. (2015) · Academic Emergency Medicine · doi:10.1111/acem.12750 · Cited by 48 · see citing works
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- Authors
- Spertus, J., Dorian, P., Bubien, R., Lewis, S., Godejohn, D., Reynolds, M. R., Lakkireddy, D. R., Wimmer, A. P., Bhandari, A., & Burk, C.
- Affiliations
- St. Michael's Hospital (CA)
- ORCID
- Venue
- Circulation Arrhythmia and Electrophysiology
- Published
- 2011-02
- Volume
- 4
- Issue
- 1
- Pages
- 15-25
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- OpenAlex
- W2111786081
- Cited by
- 485
- References
- 35
- Citations by year
- 2026: 35 · 2025: 48 · 2024: 60 · 2023: 42 · 2022: 46 · 2021: 49 · 2020: 36 · 2019: 38 · 2018: 15 · 2017: 28 · 2016: 20 · 2015: 15 · 2014: 15 · 2013: 9 · 2012: 17
- FWCI
- 7.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Arrhythmia and Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Social Sciences › Education › Health Education and Validation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- atrial fibrillation, health-related quality of life, patient-reported outcomes, questionnaire development, psychometric validation, catheter ablation, anticoagulation, treatment satisfaction, known-groups validity, test-retest reliability
- MeSH terms
- Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Female, Humans, Male, Middle Aged, Prospective Studies, Psychometrics, Quality of Life, Surveys and Questionnaires, Retrospective Studies, Sensitivity and Specificity, Reproducibility of Results, Outcome Assessment, Health Care
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