Quality of Life in Patients with Atrial Fibrillation

Atrial fibrillation is a common heart rhythm abnormality that is estimated to affect about 2 million Americans. Atrial fibrillation is the most common type of arrhythmia responsible for hospital admissions in the United States with an estimated 365,000 hospitalizations each year. Symptoms associated with atrial fibrillation (e.g., palpitations, shortness of breath, chest pain, dizziness) can be a source of fear and anxiety for patients and also interfere with activities of daily living and overall quality of life. Impairment of quality of life, in turn, can lead to physical and emotional disturbances and can also negatively impact the patient's social well-being.

In recent years, doctors have come to better recognize the importance of quality of life as a factor in measuring the effectiveness of various treatment modalities. Although research on the effect of various treatments on quality of life of patients with atrial fibrillation is ongoing, the following general observations have been reported to date:

• In general, studies have reported that patients with symptomatic atrial fibrillation tend to have a lower overall quality of life as compared to healthy individuals. There is also evidence that patients with symptomatic atrial fibrillation tend to have impaired quality of life as compared to patients with other cardiac problems such as people with congestive heart failure or those who have had a heart attack.

• Both rhythm control and rate control improved quality of life of patients with atrial fibrillation compared to before treatment in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study. Survival and quality of life scores were similar for both rhythm control and rate control groups in this study indicating no significant advantages of rhythm control versus rate control.

• Another study, known as the Canadian Trial of Atrial Fibrillation (CTAF), reported that quality of life improved in patients with atrial fibrillation who were treated with antiarrhythmic medications such as amiodarone, propafenone, and sotalol.

• Significant improvements in quality of life have also been reported for patients with atrial fibrillation undergoing non-pharmacological interventions including:

  • different pacing modalities (DDDR and VVIR)
  • radiofrequency catheter ablation
  • Maze procedure
  • pulmonary vein isolation