title: Patient factors associated with quality of life in atrial fibrillation.
abstract: BACKGROUND
  As treatment options for atrial fibrillation (AF) increase, more attention is focused on patients' experiences and quality of life (QoL). However, little is known about the factors associated with these outcomes.
  
  
  METHODS
  The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a disease-specific QoL tool for AF, with domain and summary scores ranging from 0 (the worst QoL) to 100. Using multivariable linear regression, we evaluated factors associated with baseline AFEQT Summary and Subscale Scores in ORBIT AF, a large, community-based AF registry. Independent associations were reported as coefficient estimates in scores and 95% confidence intervals (CI).
  
  
  RESULTS
  Overall, AFEQT was assessed in 2007 AF outpatients from 99 sites. Median age (IQR) was 76 years (67-82) and 43% were female. The median AFEQT summary score was 82 (67-94). Female sex, younger age, new onset AF, higher heart rate, obstructive sleep apnea, symptomatic heart failure (HF), chronic obstructive pulmonary disease and coronary artery disease were all independently associated with reduced QoL. Female sex [Estimate -7.03, 95% CI (-9.31, -4.75)] and new onset versus permanent AF [Estimate -7.44, 95% CI (-11.03, -3.84)] were independently associated with increased symptoms. NYHA Class III or IV HF [Estimate -14.44, 95% CI (-19.46, -8.76)] and female sex [Estimate -7.91, 95% CI (-9.95, -5.88)] were most independently associated with impaired daily activities.
  
  
  CONCLUSIONS
  QoL in patients with AF varies widely and is associated with several patient factors. Understanding patient factors independently associated with worse QoL can be a foundation for tailoring treatment.
authors.affiliation: Duke Clinical Research Institute, Durham, NC; Duke University Medical Center, Durham, NC. Electronic address: tiffany.callaway@duke.edu.
authors.forename: Tiffany C
authors.initials: TC
authors.lastname: Randolph
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: DaJuanicia N
authors.initials: DN
authors.lastname: Simon
authors.affiliation: Duke University School of Medicine, Durham, NC.
authors.forename: Laine
authors.initials: L
authors.lastname: Thomas
authors.affiliation: University of Colorado School of Medicine, Aurora, CO.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Allen
authors.affiliation: Ahmanson-UCLA Cardiomyopathy Center, Los Angeles, CA.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.affiliation: Lankenau Hospital and Medical Research Center, Philadelphia, PA.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kowey
authors.affiliation: Columbia University Medical Center, New York, NY.
authors.forename: James A
authors.initials: JA
authors.lastname: Reiffel
authors.affiliation: Penn State Hershey Medical Center, Hershey, PA.
authors.forename: Gerald V
authors.initials: GV
authors.lastname: Naccarelli
authors.affiliation: Saint Luke's Mid America Heart Institute/UMKC, Kansas City, MO.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan
authors.affiliation: Saint Luke's Mid America Heart Institute/UMKC, Kansas City, MO.
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: Duke Clinical Research Institute, Durham, NC; Duke University Medical Center, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Duke Clinical Research Institute, Durham, NC; Duke University Medical Center, Durham, NC. Electronic address: jonathan.piccini@duke.edu.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Piccini
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology