title: Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias.
abstract: BACKGROUND
  In 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life.
  
  
  OBJECTIVE
  To conduct a qualitative cross sectional survey to understand patients' perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM).
  
  
  METHODS
  Twenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis.
  
  
  RESULTS
  Participants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information.
  
  
  CONCLUSIONS
  Symptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups.
  
  
  BACKGROUND
  The study is registered on the Clinical Trials website, Identifier NCT01672528.
authors.affiliation: Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK. Kathleen.withers@wales.nhs.uk.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Withers
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA. kathryn.wood@duke.edu.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Wood
authors.affiliation: Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK. Grace.carolan-rees@wales.nhs.uk.
authors.forename: Grace
authors.initials: G
authors.lastname: Carolan-Rees
authors.affiliation: National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK. Hannah.Patrick@nice.org.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Patrick
authors.affiliation: Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK. Mauro.Lencioni@uhb.nhs.uk.
authors.forename: Mauro
authors.initials: M
authors.lastname: Lencioni
authors.affiliation: Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK. Michael.Griffith@uhb.nhs.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Griffith
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000523:psychology*; D001294:Attitude to Health; D017115:Catheter Ablation / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires