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Observational Study
. 2016 Dec:182:135-143.
doi: 10.1016/j.ahj.2016.08.003. Epub 2016 Aug 19.

Patient factors associated with quality of life in atrial fibrillation

Tiffany C Randolph  1 , DaJuanicia N Simon  2 , Laine Thomas  3 , Larry A Allen  4 , Gregg C Fonarow  5 , Bernard J Gersh  6 , Peter R Kowey  7 , James A Reiffel  8 , Gerald V Naccarelli  9 , Paul S Chan  10 , John A Spertus  10 , Eric D Peterson  11 , Jonathan P Piccini  12 ; ORBIT AF Investigators and Patients
Affiliations
Observational Study

Patient factors associated with quality of life in atrial fibrillation

Tiffany C Randolph et al. Am Heart J. 2016 Dec.

Abstract

Background: As treatment options for atrial fibrillation (AF) increase, more attention is focused on patients' experiences and quality of life (QoL). However, little is known about the factors associated with these outcomes.

Methods: The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a disease-specific QoL tool for AF, with domain and summary scores ranging from 0 (the worst QoL) to 100. Using multivariable linear regression, we evaluated factors associated with baseline AFEQT Summary and Subscale Scores in ORBIT AF, a large, community-based AF registry. Independent associations were reported as coefficient estimates in scores and 95% confidence intervals (CI).

Results: Overall, AFEQT was assessed in 2007 AF outpatients from 99 sites. Median age (IQR) was 76 years (67-82) and 43% were female. The median AFEQT summary score was 82 (67-94). Female sex, younger age, new onset AF, higher heart rate, obstructive sleep apnea, symptomatic heart failure (HF), chronic obstructive pulmonary disease and coronary artery disease were all independently associated with reduced QoL. Female sex [Estimate -7.03, 95% CI (-9.31, -4.75)] and new onset versus permanent AF [Estimate -7.44, 95% CI (-11.03, -3.84)] were independently associated with increased symptoms. NYHA Class III or IV HF [Estimate -14.44, 95% CI (-19.46, -8.76)] and female sex [Estimate -7.91, 95% CI (-9.95, -5.88)] were most independently associated with impaired daily activities.

Conclusions: QoL in patients with AF varies widely and is associated with several patient factors. Understanding patient factors independently associated with worse QoL can be a foundation for tailoring treatment.

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Figures

Figure 1
Figure 1. Factors Associated with Overall AFEQT Score
The estimate represents the difference in overall AFEQT score for each binary variable while holding all other variables constant. For example, patients with a family history of AF have a two point higher AFEQT score than patients without a family history of AF, holding all other covariates constant.
Figure 2
Figure 2
Factors Associated with Symptom Subscale Score
Figure 3
Figure 3
Factors Associated with Daily Activities Subscale Score
Figure 4
Figure 4
Factors Associated with Treatment Concern Subscale Score
Figure 5
Figure 5
Factors Associated with Treatment Satisfaction Subscale Score
See this image and copyright information in PMC

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