title: Association between the quality of life and asymptomatic episodes of paroxysmal atrial fibrillation in the J-RHYTHM II study.
abstract: BACKGROUND
  Paroxysmal atrial fibrillation (AF) patients have a reduced quality-of-life (QoL) despite the fact that the majority of AF episodes are asymptomatic. Asymptomatic AF is likely to be associated with substantial morbidity and mortality rates similar to those with symptomatic AF, whereas its effect on the QoL has not yet been clarified.
  
  
  OBJECTIVE
  We studied the specific contribution of asymptomatic AF episodes to reducing the QoL.
  
  
  METHODS
  We assessed the QoL in 233 patients with paroxysmal AF and hypertension (age 64.9 ± 9.7 years, 71% male) enrolled in the Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) using an AF-specific QoL questionnaire (AFQLQ). The AFQLQ comprised 3 components: AFQLQ1, the frequency and duration of symptoms; AFQLQ2, severity of symptoms; and AFQLQ3, limitations in daily activities and mental anxiety. Higher scores indicated a better QoL. Each patient transmitted electrocardiograms for 30s daily at a predetermined time as well as whenever arrhythmia-related symptoms were experienced. We examined the relationship between the 3 AFQLQ components and frequency of symptomatic and asymptomatic AF episodes (days/month) during 12 months of follow-up.
  
  
  RESULTS
  The symptomatic and asymptomatic AF frequencies were 0.9 ± 3.1 days/month and 1.5 ± 3.5 days/month, respectively. AFQLQ1 negatively correlated with the symptomatic AF frequency (Spearman's correlation coefficient: r = -0.332, p < 0.001). AFQLQ2 and AFQLQ3 correlated with both the symptomatic AF frequency (r = -0.27, p < 0.001 and r = -0.265, p < 0.001, respectively) and asymptomatic AF frequency (r = -0.197, p < 0.01 and r = -0.229, p < 0.005, respectively).
  
  
  CONCLUSIONS
  The asymptomatic AF episode frequency correlates with a reduced QoL in patients with paroxysmal AF, suggesting that there would be psychological benefits to its reduction.
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takeki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamazaki
authors.affiliation: Department of Clinical Trial Data Management, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtsu
authors.affiliation: Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan. Electronic address: ozakiyuk@fujita-hu.ac.jp.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Division of Cardiology, International University Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001007:Anxiety; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000523:psychology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires
keywords: Arrhythmias; Atrial fibrillation; Drug therapy; Electrocardiography; Quality-of-life