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. 2022 Feb 21;11(4):1140.
doi: 10.3390/jcm11041140.

Symptom Severity and Health-Related Quality of Life in Patients with Atrial Fibrillation: Findings from the Observational ARENA Study

Monika Sadlonova  1   2   3   4   5 , Jochen Senges  6 , Jonas Nagel  1 , Christopher Celano  4   5 , Caroline Klasen-Max  1 , Martin Borggrefe  7   8 , Ibrahim Akin  7   8 , Dierk Thomas  8   9 , Christopher Jan Schwarzbach  10 , Thomas Kleeman  11 , Steffen Schneider  6 , Matthias Hochadel  6 , Tim Süselbeck  12 , Harald Schwacke  13 , Angelika Alonso  14 , Markus Haass  15 , Karl-Heinz Ladwig  16   17 , Christoph Herrmann-Lingen  1   3
Affiliations

Symptom Severity and Health-Related Quality of Life in Patients with Atrial Fibrillation: Findings from the Observational ARENA Study

Monika Sadlonova et al. J Clin Med. .

Abstract

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with impaired health-related quality of life (HRQoL), high symptom severity, and poor cardiovascular outcomes. Both clinical and psychological factors may contribute to symptom severity and HRQoL in AF.

Methods: Using data from the observational Atrial Fibrillation Rhine-Neckar Region (ARENA) trial, we identified medical and psychosocial factors associated with AF-related symptom severity using European Heart Rhythm Association symptom classification and HRQoL using 5-level EuroQoL- 5D.

Results: In 1218 AF patients (mean age 71.1 ± 10.5 years, 34.5% female), female sex (OR 3.7, p < 0.001), preexisting coronary artery disease (CAD) (OR 1.7, p = 0.020), a history of cardioversion (OR 1.4, p = 0.041), cardiac anxiety (OR 1.2; p < 0.001), stress from noise (OR 1.4, p = 0.005), work-related stress (OR 1.3, p = 0.026), and sleep disturbance (OR 1.2, p = 0.016) were associated with higher AF-related symptom severity. CAD (β = -0.23, p = 0.001), diabetes mellitus (β = -0.25, p < 0.001), generalized anxiety (β = -0.30, p < 0.001), cardiac anxiety (β = -0.16, p < 0.001), financial stress (β = -0.11, p < 0.001), and sleep disturbance (β = 0.11, p < 0.001) were associated with impaired HRQoL.

Conclusions: Psychological characteristics, preexisting CAD, and diabetes may play an important role in the identification of individuals at highest risk for impaired HRQoL and high symptom severity in patients with AF.

Keywords: EHRA class; atrial fibrillation; health-related quality of life.

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Conflict of interest statement

J.S. has received honoraria fees for research presentations of ARENA Registry. C.C. has received salary support from BioXcel Pharmaceuticals and honoraria for talks to Sunovion Pharmaceuticals on topics unrelated to this research. D.T. reports receiving lecture fees/honoraria from Bayer Vital, Boehringer Ingelheim Pharma, Bristol-Myers Squibb, Daiichi Sankyo, Medtronic, Pfizer Pharma, Sanofi-Aventis, St. Jude Medical, and ZOLL CMS. C.J.S. has received lecture and authoring honoraria by b4c Solutions, Elsevier publishers, and Boehringer-Ingelheim, and reports a grant by the Innovationsfonds of the Gemeinsamen Bundesausschusses (G-BA). C.H-L. reports that he is receiving royalties from Hogrefe Huber Publishers for the German version of the Hospital Anxiety and Depression Scale. During the last three years, he has received lecture honoraria from Pfizer and Novartis and research support from the German Ministry of Education and Research (BMBF), the European Union, and the German Research Fund (DFG). The remaining authors do not report any conflict of interest.

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