Predictors of quality of life in patients with non-valvular atrial fibrillation-flutter

Main Article Content

O. S. Sychov
A. O. Borodai

Abstract

The aim – to identify factors that might predict reduced quality of life scores in patients with non-valvular atrial fibrillation-flutter (AF-AFl).
Material and methods. In prospective cross-sectional study we evaluated 328 patients with non-valvular AF-AFl, mean age 61.7±9.96 years, among them 126 (38.4 %) females. The quality of life was assessed by means of specific instruments AF-QоL and AFEQT.
Results. The lowest overall score by AFEQT (48.1±19.7) as well as by AF-Qol (38.3±17.6) was registered in patients with paroxysmal AF-AFl and the highest overall score – patients with persistent AF-AFl after cardioversion (68.7±20.8 and 52.5±19.1, correspondingly). In multivariate regression model independent predictors of global AF-Qol were class NYHA (β=0.22, Р<0.001), HADS anxiety (β=–0.21, Р<0.001), HADS depression (β=–0.20, Р<0.001), paroxysmal form of arrhythmia (β=–0.16, Р=0.001), CHA2DS2VASc score (β=–0.6, Р=0.002). Independent predictors of the overall AFEQT score were class NYHA (β=–0.38, Р<0.001), HADS anxiety (β=–0.25, Р<0.001), female gender (β=–0.22, Р<0.001) and paroxysmal form of arrhythmia (β=–0.14, Р=0.001).
Conclusions. Heart failure class NYHA, symptoms of anxiety, depression, female gender and paroxysmal form of arrhythmia were associated with significantly reduced quality of life in patients with non-valvular atrial fibrillation-flutter.

Article Details

Keywords:

atrial fibrillation, atrial flutter, quality of life

References

Сичов О.С., Бородай А.О. Валідація російськомовної версії опитувальника AF-QоL у пацієнтів з фібриляцією і тріпотінням передсердь неклапанного походження // Укр. кардіол. журн.– 2016.– № 5.– С. 58–66.

Сичов О.С., Бородай А.О., Бородай Е.С. та ін. Валідація російськомовної версії опитувальника Atrial Fibrillation Effect on QualiTy-of-Life у пацієнтів з фібриляцією і тріпотінням передсердь неклапанного походження // Укр. кардіол. журн.– 2016.– № 4.– С. 97–106.

Akintade B.F., Chapa D., Friedmann E., Thomas S.A. The influence of depression and anxiety symptoms on health-related quality of life in patients with atrial fibrillation and atrial flutter // J. Cardiovasc. Nurs.– 2015.– Vol. 30 (1).– Р. 66–73.

Aliot E., Botto G.L., Crijns H.J., Kirchhof P. Quality of life in patients with atrial fibrillation: how to assess it and how to improve it // Europace.– 2014.– Vol. 16 (6).– P. 787–796.

Arribas F., Ormaetxe X., Peinado R. et al. Validation of the AF-QоL, a disease-specific quality of life questionnaire for patients with atrial fibrillation // Europace.– 2010.– Vol. 12.– P. 364–370.

Bai Y., Bai R., Wu J.-H. et al. Differences in Quality of Life Between Atrial Fibrillation Patients with Low Stroke Risk Treated With and Without Catheter Ablation // J. Amer. Heart Association: Cardiovasc. Cerebrovasc. Disease.– 2015.– Vol. 4 (9).– P. e002130. doi:10.1161/JAHA.115.002130

Bjelland I., Dahl A.A., Haug T.T., Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review // J. Psychosom. Res.– 2002.– Vol. 52 (2).– Р. 69–77.

Cleophas T.J., Zwinderman A.J., Cleophas T.F., Cleophas E.P. Statistics Applied to Clinical Trials.– 4th ed.– Springer Science + Business Media B.V., 2009.

Dagres N., Nieuwlaat R., Vardas P.E. et al. Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: A report from the Euro Heart Survey on Atrial Fibrillation // J. Am. Coll. Cardiol.– 2007.– Vol. 49. – P. 572–577.

Dorian P., Paquette M., Newman D. et al. Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation // Amer. Heart J. – 2002.– Vol. 143.– P. 984–990.

Gehi A.K., Sears S., Goli N. et al. Psychopathology and symptoms of atrial fibrillation: implications for therapy // J. Cardiovasc. Electrophysiology.– 2012.– Vol. 23, N 5.– P. 473–478.

Kirchhof P., Benussi S., Kotecha D. et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO) // Eur. J. Cardiothorac. Surg.– 2016.– Vol. 50 (5).– Р. e1–e88.

Lang R.M., Badano L.P., Mor-Avi V. et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging // J. Am. Soc. Echocardiogr.– 2015.– Vol. 28 (1).– P. 1–39.

Lioni L., Vlachos K., Letsas K.P. et al. Differences in quality of life, anxiety and depression in patients with paroxysmal atrial fibrillation and common forms of atrioventricular reentry supraventricular tachycardias // Indian. Pacing Electrophysiol. J.– 2014.– Vol. 14 (5).– P. 250–257.

Lopez O.L., Jagust W.J., DeKosky S.T. Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1 // Arch. Neurol.– 2003.– Vol. 60 (10). – P. 1385–1389.

Nagueh S., Appleton C., Gillebert T. et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography // J. Am. Soc. Echocardiogr.– 2009.– Vol. 22 (2).– P. 107–133.

Raine D., Langley P., Shepherd E. et al. Effect of catheter ablation on quality of life in patients with atrial fibrillation and its correlation with arrhythmia outcome // Open Heart.– 2015.– Vol. 2 (1).– P. 2:e000302.

Reynolds M.R., Lavelle T., Essebag V. et al. Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: The Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study // Am. Heart J.– 2006.– Vol. 152.– P. 1097–1103.

Schnabel R.B., Michal M., Wilde S. et al. Depression in Atrial Fibrillation in the General Population // PLoS ONE.– 2013.– Vol. 8 (12).– P. e79109. doi:10.1371/journal.pone.0079109.

Thompson T.S., Barksdale D.J., Sears S.F. et al. The effect of anxiety and depression on symptoms attributed to atrial fibrillation // Pacing. Clin. Electrophysiol.– 2014.– 37 (4).– P. 439–446.

Von Eisenhart Rothe A., Hutt F., Baumert J. et al. Depressed mood amplifies heart-related symptoms in persistent and paroxysmal atrial fibrillation patients: a longitudinal analysis-data from the German Competence Network on Atrial Fibrillation // Europace.– 2015.– Vol. 17 (9).– P. 1354–1362.

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