title: The Impact of Duration of Atrial Fibrillation Recurrences on Measures of Health-Related Quality of Life and Symptoms.
abstract: BACKGROUND
  Little is known about the relationship between daily atrial fibrillation (AF) burden and quality of life (QOL). We sought to determine the influence of atrial tachycardia (AT) or AF burden on measures of QOL and symptoms.
  
  
  RESULTS
  We retrospectively analyzed patients with dual-chamber pacemakers from the Atrial Septal Pacing Efficacy Clinical Trial (ASPECT), Atrial Therapy Efficacy and Safety Trial (ATTEST), and aTRial arrhythmias dEtected by implaNted Device diagnostics Study (TRENDS) trials. All patients underwent at least one QOL evaluation. We predefined four AF burden groups: no AT/AF (group 1), ≤30 minutes (group 2), 30 minutes-2 hours (group 3), and >2 hours (group 4) per day. We compared QOL measures using the 12-item Short-Form Health Survey (SF-12; standard 4 week recall) and the AF Symptom Checklist (SC) severity and frequency between groups 2-4 to those in group 1. A total of 798 patients were analyzed (age 72 ± 11 years, 447 male [56%]). SC frequency and severity and SF-12 physical and mental scores worsened significantly when patients in group 4 were compared to patients with no AF. There were no statistically significant differences for any of the measures when comparing group 2 or 3 patients to group 1. By linear regression, only the 2-hour-cutoff had a significant impact on QOL as measured by SC frequency (+3.15, P < 0.001), severity (+3.23, P < 0.001), SF-12 physical score (-2.42, P = 0.013), and SF-12 mental score (-2.11, P = 0.021).
  
  
  CONCLUSIONS
  A daily AT/AF burden of more than 2 hours had significant impact on QOL. This might influence the choice of appropriate cut-off points to determine the success of an AF treatment.
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Kochhäuser
authors.affiliation: McGill University Health Center, McGill University, Montreal, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Joza
authors.affiliation: McGill University Health Center, McGill University, Montreal, Canada.
authors.forename: Vidal
authors.initials: V
authors.lastname: Essebag
authors.affiliation: McGill University Health Center, McGill University, Montreal, Canada.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Proietti
authors.affiliation: Medtronic Cardiac Rhythm Heart Failure Division, Mounds View, Minnesota.
authors.forename: Jodi
authors.initials: J
authors.lastname: Koehler
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Bernice
authors.initials: B
authors.lastname: Tsang
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Zaev
authors.initials: Z
authors.lastname: Wulffhart
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pantano
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Yaariv
authors.initials: Y
authors.lastname: Khaykin
authors.affiliation: Medtronic Cardiac Rhythm Heart Failure Division, Mounds View, Minnesota.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Ziegler
authors.affiliation: Southlake Regional Health Centre, Newmarket, Canada.
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: AF ablation; atrial fibrillation; outcome; quality of life; symptoms