Quality of life in atrial fibrillation: the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.
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.
Jenkins
Louise S
LS
School of Nursing, University of Maryland, Baltimore, Md 21201-1579, USA. Jenkins@son.umaryland.edu
Brodsky
Michael
M
Schron
Eleanor
E
Chung
Mina
M
Rocco
Thomas
T
Lader
Ellis
E
Constantine
Martha
M
Sheppard
Robert
R
Holmes
Donald
D
Mateski
Donna
D
Floden
Liz
L
Prasun
Marilyn
M
Greene
H Leon
HL
Shemanski
Lynn
L
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
D000889:Anti-Arrhythmia Agents