title: A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale.
abstract: BACKGROUND
  The severity of symptoms caused by atrial fibrillation (AF) is extremely variable. Quantifying the effect of AF on patient well-being is important but there is no simple, commonly accepted measure of the effect of AF on quality of life (QoL). Current QoL measures are cumbersome and impractical for clinical use.
  
  
  OBJECTIVE
  To create a simple, concise and readily usable AF severity score to facilitate treatment decisions and physician communication.
  
  
  METHODS
  The Canadian Cardiovascular Society (CCS) Severity of Atrial Fibrillation (SAF) Scale is analogous to the CCS Angina Functional Class. The CCS-SAF score is determined using three steps: documentation of possible AF-related symptoms (palpitations, dyspnea, dizziness/syncope, chest pain, weakness/fatigue); determination of symptom-rhythm correlation; and assessment of the effect of these symptoms on patient daily function and QoL. CCS-SAF scores range from 0 (asymptomatic) to 4 (severe impact of symptoms on QoL and activities of daily living). Patients are also categorized by type of AF (paroxysmal versus persistent/permanent). The CCS-SAF Scale will be validated using accepted measures of patient-perceived severity of symptoms and impairment of QoL and will require 'field testing' to ensure its applicability and reproducibility in the clinical setting.
  
  
  CONCLUSIONS
  This type of symptom severity scale, like the New York Heart Association Functional Class for heart failure symptoms and the CCS Functional Class for angina symptoms, trades precision and comprehensiveness for simplicity and ease of use at the bedside. A common language to quantify AF severity may help to improve patient care.
authors.affiliation: Division of Cardiology, St. Michael's Hospital, University of Toronto, Ontario, Canada. dorianp@smh.toronto.on.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
authors.forename: Suzan S
authors.initials: SS
authors.lastname: Cvitkovic
authors.forename: Charles R
authors.initials: CR
authors.lastname: Kerr
authors.forename: Eugene
authors.initials: E
authors.lastname: Crystal
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gillis
authors.forename: Peter G
authors.initials: PG
authors.lastname: Guerra
authors.forename: L Brent
authors.initials: LB
authors.lastname: Mitchell
authors.forename: Denis
authors.initials: D
authors.lastname: Roy
authors.forename: Allan C
authors.initials: AC
authors.lastname: Skanes
authors.forename: D George
authors.initials: DG
authors.lastname: Wyse
mesh_terms: D001281:Atrial Fibrillation / Q000145:classification* / Q000150:complications / Q000175:diagnosis*; D002170:Canada; D002309:Cardiology / Q000295:instrumentation*; D002637:Chest Pain / Q000209:etiology; D004244:Dizziness / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D006801:Humans; D019095:Point-of-Care Systems; D011788:Quality of Life; D012720:Severity of Illness Index; D012955:Societies, Medical