title: Quality of life in atrial fibrillation: the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.
abstract: OBJECTIVE
  The objective of this prespecified substudy of the AFFIRM study, in which no differences in survival or event rates were found in patients with atrial fibrillation (AF) randomized to either rate control or rhythm control, was to test the null hypothesis that quality of life (QoL) is equal with rate- versus rhythm-control treatment strategies in AF.
  
  
  METHODS
  Fifty-six (25%) of AFFIRM sites were randomly selected to recruit AFFIRM patients for the QoL substudy. Instruments used in the QoL assessment were (1) Perceived Health; (2) the Cantril Ladder of Life; (3) the Short Form 36 survey; (4) the QoL Index; and (5) the Symptom Checklist: Frequency and Severity. Data were collected at baseline, 2 months, 12 months, and annually; data are reported through 4 years of follow-up.
  
  
  RESULTS
  Baseline characteristics of the AFFIRM QoL patients (n = 716) were generally similar to those of the rest of AFFIRM patients. Quality-of-life scores were similar in rate- and rhythm-control assignment groups at all time points. Quality-of-life scores were similar whether the actual rhythm was sinus or AF. Scores increased from baseline to subsequent time points similarly for both groups; these improvements were not additive over time.
  
  
  CONCLUSIONS
  Quality of life was comparable between rate- and rhythm-control treatment strategies. In addition, QoL was similar with sinus rhythm versus AF. Attempts to improve QoL by restoring sinus rhythm will usually be unsuccessful.
authors.affiliation: School of Nursing, University of Maryland, Baltimore, Md 21201-1579, USA. Jenkins@son.umaryland.edu
authors.forename: Louise S
authors.initials: LS
authors.lastname: Jenkins
authors.forename: Michael
authors.initials: M
authors.lastname: Brodsky
authors.forename: Eleanor
authors.initials: E
authors.lastname: Schron
authors.forename: Mina
authors.initials: M
authors.lastname: Chung
authors.forename: Thomas
authors.initials: T
authors.lastname: Rocco
authors.forename: Ellis
authors.initials: E
authors.lastname: Lader
authors.forename: Martha
authors.initials: M
authors.lastname: Constantine
authors.forename: Robert
authors.initials: R
authors.lastname: Sheppard
authors.forename: Donald
authors.initials: D
authors.lastname: Holmes
authors.forename: Donna
authors.initials: D
authors.lastname: Mateski
authors.forename: Liz
authors.initials: L
authors.lastname: Floden
authors.forename: Marilyn
authors.initials: M
authors.lastname: Prasun
authors.forename: H Leon
authors.initials: HL
authors.lastname: Greene
authors.forename: Lynn
authors.initials: L
authors.lastname: Shemanski
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation; D003627:Data Interpretation, Statistical; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006339:Heart Rate; D006801:Humans; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012107:Research Design
chemical_list: D000889:Anti-Arrhythmia Agents