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. 2020 Jun 16:29:100556.
doi: 10.1016/j.ijcha.2020.100556. eCollection 2020 Aug.

Symptoms and quality of life in patients with coexistent atrial fibrillation and atrial flutter

Samuel Stempfel  1   2 , Stefanie Aeschbacher  1   2 , Steffen Blum  1   2 , Pascal Meyre  1   2 , Rebecca Gugganig  1   2 , Jürg H Beer  3 , Richard Kobza  4 , Michael Kühne  1   2 , Giorgio Moschovitis  5 , Gianluca Menghini  1   2 , Jan Novak  6 , Stefan Osswald  1   2 , Nicolas Rodondi  7   8 , Elisavet Moutzouri  7   8 , Matthias Schwenkglenks  9 , Fabienne Witassek  9 , David Conen  1   2   10 , Christian Sticherling  1   2 ; Swiss-AF study investigators
Affiliations

Symptoms and quality of life in patients with coexistent atrial fibrillation and atrial flutter

Samuel Stempfel et al. Int J Cardiol Heart Vasc. .

Abstract

Aims: Atrial fibrillation (AF) and atrial flutter (AFL) are two of the most common atrial arrhythmias and often coexist. Many patients with AF or AFL are symptomatic, which impacts their quality of life (QoL). The purpose of this study was to determine whether coexistent AFL represents an added burden for AF patients.

Methods: We combined baseline data from two large prospective, observational, multicenter cohort studies (BEAT-AF and Swiss-AF). All 3931 patients included in this analysis had documented AF. We obtained information on comorbidities, medication, and lifestyle factors. All participants had a clinical examination and a resting ECG. Symptom burden and QoL at the baseline examination were compared between patients with and without coexistent AFL using multivariable adjusted regression models.

Results: Overall, 809 (20.6%) patients had a history of AFL. Patients with coexistent AFL more often had history of heart failure (28% vs 23%, p = 0.01), coronary artery disease (30% vs 26%, p = 0.007), failed therapy with antiarrhythmic drugs (44% vs 29%, p < 0.001), and more often underwent AF-related interventions (36% vs 17%, p < 0.001). They were more often symptomatic (70% vs 66%, p = 0.04) and effort intolerant (OR: 1.14; 95% CI: 1.01-1.28; p = 0.04). Documented AFL on the baseline ECG was associated with more symptoms (OR: 2.30; 95% CI: 1.26-4.20; p = 0.007).

Conclusion: Our data indicates that patients with coexistent AF and AFL are more often symptomatic and report poorer quality of life compared to patients suffering from AF only.

Keywords: Atrial fibrillation; Atrial flutter; Quality of life; Symptoms.

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