Author + information
- Received September 15, 2016
- Revision received November 22, 2016
- Accepted December 8, 2016
- Published online May 15, 2017.
- Emmanouil Charitakis, MD, PhDa,b,∗ (, )
- Neshro Barmano, MDb,c,
- Ulla Walfridsson, RN, PhDa,b and
- Håkan Walfridsson, MD, PhDa,b
- aDepartment of Cardiology, Linköping University Hospital, Linköping, Sweden
- bDepartment of Medical and Health Sciences, Linköping University, Linköping, Sweden
- cDepartment of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
- ↵∗Address for correspondence:
Emmanouil Charitakis, Department of Cardiology, Linköping University Hospital, Garnisonsvägen, 10 581 85, Linköping, Sweden.
Objectives The purpose of this study was to correlate the arrhythmia-related symptoms and health-related quality of life (HRQoL) in patients with atrial fibrillation (AF) who are eligible for radiofrequency ablation (RFA) with a number of objective indicators.
Background Although the clinical consequences of AF have been studied extensively, the variation in the symptoms of patients with AF and HRQoL remains under-researched.
Methods We studied 192 patients eligible for RFA of AF referred to the University Hospital, Linköping, Sweden, between January 2012 and April 2014. The ASTA (Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia) symptom scale was used to assess arrhythmia-related symptoms in the patients. The ASTA HRQoL scale and the short-form 36 (SF-36) physical and mental components summaries (PCS and MCS) were used to express disease-specific and overall HRQoL of the patients, respectively.
Results Anxiety, low-grade inflammation, and left atrial dilatation significantly predicted arrhythmia-related symptoms (R2 = 0.313; p < 0.001). Depression was the most important predictor of arrhythmia-specific HRQoL (standardized beta: 0 .406), and the produced model explained a significant proportion of the variation in arrhythmia-specific HRQoL (R2 = 0.513; p < 0.001). The most important predictor of PCS was obesity (body mass index >30 kg/m2) (standardized beta: −0.301), whereas the most important predictor of MCS was anxiety (standardized beta: −0.437).
Conclusions Anxiety, depression, and low-grade inflammation were the factors that predicted both arrhythmia-related symptoms and HRQoL in patients with AF. Obesity was the most significant predictor of patient general physical status. These factors need to be addressed in patients with AF to improve management of their disease. Intensive risk factor modification can be of great importance. (Reasons for Variations in Health Related Quality of Life and Symptom Burden in Patients With Atrial Fibrillation [SMURF]; NCT01553045)
The SMURF study is supported by grants from ALF grants (County Council of Östergötland), the Carldavid Jönsson Research Foundation, the Heart Foundation, Linköping University, and by unrestricted grants from Biosense Webster and Johnson & Johnson.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received September 15, 2016.
- Revision received November 22, 2016.
- Accepted December 8, 2016.
- 2017 American College of Cardiology Foundation