Quality of life and depression in patients with different patterns of atrial fibrillation.
BACKGROUND
atrial fibrillation (AF) is difficult to cure and significantly affects quality of life was well as emotional status of patients.


OBJECTIVE
to evaluate quality of life and depression level in patients with various patterns of AF.


METHODS
we studied 150 consecutive patients with AF aged 35-83 years, including 61 patients with paroxysmal AF, 46 patients with persistent AF, and 43 patients with permanent AF. The control group included 70 healthy persons (mean age: 55.5 ± 14.5 years). Quality of life was estimated using the Nottingham Health Profile questionnaire. Risk of depression occurrence was estimated using the Beck Depression Inventory scale. Physical abilities, energy level, pain, emotional reactions, sleep, social isolation, problems with work, family life and sexual life were analysed.


RESULTS
the mean age of patients with paroxysmal AF was higher in comparison to patients with permanent AF (68.4 ± 9.4 vs 62.0 ± 9.2 years, p < 0.05). In patients with all AF forms, the prevalence of symptoms indicating depression was significantly higher in comparison with control group (paroxysmal AF: 10.8 ± 5.8%, persistent AF: 10.0 ± 6.4%, permanent AF: 10.1 ± 7.2% vs 5.7 ± 5.8% in controls, p < 0.01). The level of depression was higher in women regardless of AF form (p < 0.005). Patients with paroxysmal and permanent AF had lower scores of emotional reactions (p < 0.05) and social isolation (p < 0.05) in comparison with the control group. All patients with AF had lower scores of energy level in comparison with the control group (paroxysmal AF: 1.2 ± 0.2, persistent AF: 1.1 ± 0.2, permanent AF: 1.2 ± 0.2 vs 0.5 ± 0.1 in controls, p < 0.005). Patients with paroxysmal, persistent and permanent AF had greater degree of activity limitations than the control group (1.8 ± 0.2, 1.7 ± 0.3, 2.1 ± 0.3, respectively, vs 1.0 ± 0.2, p < 0.005). Limitations of work were detected in 28.6-35.9% of patients with various forms of AF, sex life disturbances in 23.8-33.9% of patients, and family life problems in 10.3-21.4% of patients. The lowest results of these scores were noted in patients with paroxysmal AF.


CONCLUSIONS
atrial fibrillation, independently of its form, has substantial impact on the risk of depression occurrence. Patients with paroxysmal and permanent AF had lower self-evaluation of their energy level. In all studied groups of AF patients, the arrhythmia significantly limited quality of life, especially sexual life as well as professional and home activity.
Institute of Cardiology, 2nd Ischaemic Heart Disease Department, Warsaw, Poland. rdabrowski45@gmail.com
Rafał
R
Dąbrowski
Edyta
E
Smolis-Bąk
Ilona
I
Kowalik
Barbara
B
Kazimierska
Mariola
M
Wójcicka
Hanna
H
Szwed
D000203:Activities of Daily Living; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D012931:Social Environment; D011795:Surveys and Questionnaires