title: Symptom Clusters in Adults With Chronic Atrial Fibrillation.
abstract: BACKGROUND
  Symptom clusters have not previously been explored among individuals with atrial fibrillation of any type.
  
  
  OBJECTIVE
  The purpose of this study is to determine the number of symptom clusters present among adults with chronic atrial fibrillation and to explore sociodemographic and clinical factors potentially associated with cluster membership.
  
  
  METHODS
  This was a cross-sectional secondary data analysis of 335 Australian community-dwelling adults with chronic (recurrent paroxysmal, persistent, or permanent) atrial fibrillation. We used self-reported symptoms and agglomerative hierarchical cluster analysis to determine the number and content of symptom clusters present.
  
  
  RESULTS
  There were slightly more male (52%) than female participants, with a mean (SD) age of 72 (11.25) years. Three symptom clusters were evident, including a vagal cluster (nausea and diaphoresis), a tired cluster (fatigue/lethargy, weakness, syncope/dizziness, and dyspnea/breathlessness), and a heart cluster (chest pain/discomfort and palpitations/fluttering). We compared patient characteristics among those with all the symptoms in the cluster, those with some of the symptoms in the cluster, and those with none of the symptoms in the cluster. The only statistically significant differences were in age, gender, and the use of antiarrhythmic medications for the heart cluster. Women were more likely to have the heart symptom cluster than men were. Individuals with all of the symptoms in the heart cluster were younger (69.6 vs 73.7 years; P = .029) than those with none of the symptoms in the heart cluster and were more likely to be on antiarrhythmic medications.
  
  
  CONCLUSIONS
  Three unique atrial fibrillation symptom clusters were identified in this study population.
authors.affiliation: Megan Streur, RN, MN Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia. Sarah J. Ratcliffe, PhD Associate Professor, Division of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Jocasta Ball, PhD Postdoctoral Research Fellow, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. Simon Stewart, PhD, RN Professor, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. Barbara Riegel, PhD, RN Professor, School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Megan
authors.initials: M
authors.lastname: Streur
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Jocasta
authors.initials: J
authors.lastname: Ball
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D001315:Australia; D002908:Chronic Disease; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D063189:Symptom Assessment