title: Exercise tolerance and quality of life in elderly patients with chronic atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation is the most common arrhythmia affecting the elderly. Although the risk of cardioembolic stroke is well defined, the effects of chronic atrial fibrillation on exercise tolerance and quality of life have been less well quantified.
  
  
  METHODS
  We compared a group of 52 elderly patients with chronic atrial fibrillation to a group of 48 control patients in sinus rhythm. Each patient underwent an interview that incorporated the Short Form-36 Health Survey (SF-36) to quantify individual perceptions on quality of life. In addition each person underwent physiologic testing that included a Modified Bruce Protocol exercise tolerance test, 24-hour ambulatory monitor test, and an echocardiogram.
  
  
  RESULTS
  Both groups were elderly, 77 vs 76 years of age (P=0.35). The two groups had similar ejection fractions, 55.4% vs 58.4% (P=0.10). The atrial fibrillation patients demonstrated a higher level of comorbidity based on the Charlson Comorbidity Index, 2.46 vs 1.57 (P=0.03). On formal exercise testing there was no statistical difference in exercise duration between the two groups 9.0 vs 10.1 minutes (P=0.24). Similarly the Physical Summary Score (PCS) and the Mental Summary Score (MCS) of the SF-36 quality of life survey did not demonstrate a statistical difference between the two groups. PCS: 43.0 vs 45.9 (P=0.24);
  52.5 vs 55.7 (P=0.07).
  
  
  CONCLUSIONS
  Despite a higher level of comorbidity, elderly, ambulatory patients with chronic atrial fibrillation demonstrate similar exercise tolerance and report similar quality of life to a group of age-matched control patients in sinus rhythm. There is a cohort of patients in chronic atrial fibrillation in whom a strategy of rate control and anticoagulation may be appropriate.
authors.affiliation: Yale School of Medicine New Haven, CT, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Howes
authors.forename: M C
authors.initials: MC
authors.lastname: Reid
authors.forename: C
authors.initials: C
authors.lastname: Brandt
authors.forename: B
authors.initials: B
authors.lastname: Ruo
authors.forename: M W
authors.initials: MW
authors.lastname: Yerkey
authors.forename: B
authors.initials: B
authors.lastname: Prasad
authors.forename: C
authors.initials: C
authors.lastname: Lin
authors.forename: P
authors.initials: P
authors.lastname: Peduzzi
authors.forename: M D
authors.initials: MD
authors.lastname: Ezekowitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D002908:Chronic Disease; D015897:Comorbidity; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D000925:Anticoagulants