Quality of life in patients with atrial fibrillation: how to assess it and how to improve it.
Atrial fibrillation (AF) is the most frequent cardiac rhythm disorder and presents a considerable public health burden that is likely to increase in the next decades due to the ageing population. Current management strategies focus on the heart rate and rhythm control, thromboembolism prevention, and treatment of underlying diseases. The concept of quality of life (QoL) has gained significant importance in recent years as an outcome measure in AF studies evaluating therapeutic interventions and as a relevant component of a comprehensive treatment plan. Quality of life is impaired in the majority of patients with AF, and both rate and rhythm control strategies show significant improvement in QoL measures in highly symptomatic patients. This article reviews generic and specialized instruments for measuring QoL in the context of AF, discusses their applications and limitations to integration in clinical practice, and addresses the potential of early therapy for improving QoL outcomes. The development and validation of new QoL assessment tools will have a central role in the advancement of therapies and treatment guidelines for AF.
Cardiology Department, Institut Lorrain du Coeur et des Vaisseaux, CHU de Nancy, 54500 Vandoeuvre-lès-Nancy Cedex, France e.aliot@chu-nancy.fr.
Etienne
E
Aliot
Cardiology Department, S. Anna Hospital, Como, Italy.
Giovanni L
GL
Botto
Department of Cardiology and CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
Harry J
HJ
Crijns
University of Birmingham Centre for Cardiovascular Sciences and SWBH NHS Trust, Institute for Biomedical Research, Birmingham B15 2TT, UK Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany.
Paulus
P
Kirchhof
D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome
Atrial fibrillation (AF); Cardiac rhythm disorder; Management strategies; Quality of life (QoL); Rate control; Rhythm control