title: Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation.
abstract: BACKGROUND
  The impact of atrial fibrillation (AF) and its treatment on health-related quality of life (QOL) is not well understood. We assessed QOL in patients with symptomatic AF participating in the Canadian Trial of Atrial Fibrillation.
  
  
  METHODS
  Self-report QOL questionnaires including the Short-Form-36 (SF-36), symptom checklist (SCL) and AF Severity Scale (AFSS) were completed at baseline and 3, and 12 months after randomization.
  
  
  RESULTS
  The study group was aged 65 +/- 10 years and 59% were male. By design, 50% of patients were randomized to amiodarone (n = 132), 25% to sotalol (n = 66), and 25% to propafenone (n = 66). Most patients had normal left ventricular function (89%). Physical (41.9 +/- 9.3 to 43.7 +/- 9.2, P =.001) and mental health (47.5 +/- 10.5 to 49.0 +/- 9.8, P =.023) summary measures from the SF-36 improved significantly from baseline to 3 months. Arrhythmia symptom frequency and severity (SCL) also improved markedly from baseline to 3 months (symptom frequency 20.4 +/- 9.4 to 16.2 +/- 9.5 and symptom severity 16.7 +/- 8.2 to 12.9 +/- 7.4, both P <.001). QOL improvements were not significantly different among the groups randomized to amiodarone, sotalol, or propafenone. However, patients with no symptomatic recurrences of AF had higher scores at 3 months on measures of global well-being than those with recurrences in the first 3 months (7.4 +/- 1.8 vs 6.9 +/- 1.8, P <.05). There were no significant QOL changes from the 3 to 12 month assessment.
  
  
  CONCLUSIONS
  In patients with symptomatic AF, QOL improves after treatment, independent of the specific drug used for treatment. This is especially true for patients in whom treatment prevents AF recurrence.
authors.affiliation: Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. dorianp@smh.toronto.on.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
authors.forename: Miney
authors.initials: M
authors.lastname: Paquette
authors.forename: David
authors.initials: D
authors.lastname: Newman
authors.forename: Martin
authors.initials: M
authors.lastname: Green
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Connolly
authors.forename: Mario
authors.initials: M
authors.lastname: Talajic
authors.forename: Denis
authors.initials: D
authors.lastname: Roy
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D002170:Canada; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D011405:Propafenone / Q000627:therapeutic use; D011788:Quality of Life; D012008:Recurrence; D012044:Regression Analysis; D012720:Severity of Illness Index; D013015:Sotalol / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D013015:Sotalol; D000638:Amiodarone