Assessment of the quality of life in patients with atrial fibrillation – critical view on the current methods and insights for the future

Iva Šafaříková ^{1, 2}, Alan Bulava ^{1, 2
1} University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, České Budějovice, Czech Republic ² Hospital České Budějovice, Department of Cardiology, České Budějovice, Czech Republic

Korespondenční autor: Iva Šafaříková (iva.safarikova@seznam.cz)

ISSN 1804-7181 (On-line)

Full verze:

Submitted:1. 2. 2021
Accepted: 22. 2. 2021
Published online: 30. 6. 2021

Summary

Abstract Atrial fibrillation (AF) represents the most common supraventricular arrhythmia of clinical significance associated with increased mortality and morbidity, especially stroke and heart failure. While AF is rarely lifethreatening arrhythmia, the symptoms may vary from totally asymptomatic in up to a one third of affected population to severe symptoms deteriorating significantly patients’ quality of life (QoL). There is currently no globally adopted guidelines on how to assess QoL in patients with AF and AF-associated QoL may be viewed from many perspectives, representing an extensive multidimensional construct. Numerous QoL instruments have been used in AF studies to date, again indicating the lack of general consensus. QoL measurement tools may be divided into two categories: generic instruments and AF-specific instruments or symptom scales. This minireview focuses on recently used questionnaires and proposing a novel, holistic method of QoL assessment in patients with AF.

Keywords: Assessment; Atrial fibrillation; Generic instruments; Quality of life; Specific instruments

Literatura

1. Badia X, Arribas F, Ormaetxe JM, Peinado R, de Los Terreros MS (2007). Development of a questionnaire to measure health-related quality of life (HRQoL) in patients with atrial fibrillation (AF-QoL). Health Qual Life Outcomes 5: 37. DOI: 10.1186/1477–7525–5–37.

2. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998). Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98(10): 946–952. DOI: 10.1161/01.cir­.98.10.946.

3. Berry C, Stewart S, Payne EM, McArthur JD, McMurray JJ (2001). Electrical cardioversion for atrial fibrillation: outcomes in “real-life” clinical practice. Int J Cardiol 81(1): 29–35. DOI: 10.1016/s0167– 5273(01)00522–8.

4. Braganca EO, Filho BL, Maria VH, Levy D, de Paola AA (2010). Validating a new quality of life questionnaire for atrial fibrillation patients. Int J Cardiol 143(3): 391–398. DOI: 10.1016/j. ijcard.2009.03.087.

5. Bubien RS, Knotts-Dolson SM, Plumb VJ, Kay GN (1996). Effect of radiofrequency catheter ablation on health-related quality of life and activities of daily living in patients with recurrent arrhythmias. Circulation 94(7): 1585–1591. DOI: 10.1161/01.cir­.94.7.1585.

6. Carlsson J, Miketic S, Windeler J, Cuneo A, Haun S, Micus S, et al. (2003). Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. J Am Coll Cardiol 41(10): 1690–1696. DOI: 10.1016/s0735– 1097(03)00332–2.

7. Chen MS, Marrouche NF, Khaykin Y, Gillinov AM, Wazni O, Martin DO, et al. (2004). Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol 43(6): 1004–1009. DOI: 10.1016/j.jac­c.2003.09.056.

8. Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ (2001). Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol 37(2): 371–378. DOI: 10.1016/ s0735–1097(00)01107–4.

9. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. (2014). Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation 129(8): 837–847. DOI: 10.1161/CIRCU­LATIONAHA.113­.005119.

10. Dagres N, Nieuwlaat R, Vardas PE, Andresen D, Levy S, Cobbe S, et al. (2007). 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 49(5): 572–577. DOI: 10.1016/j.jac­c.2006.10.047.

11. Dorian P, Cvitkovic SS, Kerr CR, Crystal E, Gillis AM, Guerra PG, et al. (2006). A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale. Can J Cardiol 22(5): 383–386. DOI: 10.1016/s0828–282×(06)70922–9.

12. Dorian P, Guerra PG, Kerr CR, O’Donnell SS, Crystal E, Gillis AM, et al. (2009). Validation of a new simple scale to measure symptoms in atrial fibrillation: the Canadian Cardiovascular Society Severity in Atrial Fibrillation scale. Circ Arrhythm Electrophysiol 2(3): 218–224. DOI: 10.1161/ CIRCEP.108.812347.

13. Dorian P, Jung W, Newman D, Paquette M, Wood K, Ayers GM, et al. (2000). The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy. J Am Coll Cardiol 36(4): 1303–1309. DOI: 10.1016/s0735– 1097(00)00886-x.

14. Dorian P, Paquette M, Newman D, Green M, Connolly SJ, Talajic M, et al. (2002). Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation. Am Heart J 143(6): 984–990. DOI: 10.1067/mhj.2002­.122518.

15. Erdogan A, Carlsson J, Neumann T, Berkowitsch A, Neuzner J, Hamm CHW, et al. (2003). Qualityof- life in patients with paroxysmal atrial fibrillation after catheter ablation: results of long-term follow-up. Pacing Clin Electrophysiol 26(3): 678–684. DOI: 10.1046/j.1460–9592.2003.00117.x.

16. European Heart Rhythm A, European Association for Cardio-Thoracic S, Camm AJ, Kirchhof P, Lip GY, Schotten U, et al. (2010). Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 31(19): 2369–2429. DOI: 10.1093/eurhe­artj/ehq278.

17. EuroQol Group (1990). EuroQol – a new facility for the measurement of health-related quality of life. Health Policy 16(3): 199–208. DOI: 10.1016/0168–8510(90)90421–9.

18. Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL (2005). Conceptual model of health-related quality of life. J Nurs Scholarsh 37(4): 336–342. DOI: 10.1111/j.1547–5069.2005.00058.x.

19. Hagens VE, Ranchor AV, Van Sonderen E, Bosker HA, Kamp O, Tijssen JGP, et al. (2004). Effect of rate or rhythm control on quality of life in persistent atrial fibrillation. Results from the Rate Control Versus Electrical Cardioversion (RACE) Study. J Am Coll Cardiol 43(2): 241–247. DOI: 10.1016/j. jacc.2003.08.037.

20. Harden M, Nystrom B, Kulich K, Carlsson J, Bengtson A, Edvardsson N (2009). Validity and reliability of a new, short symptom rating scale in patients with persistent atrial fibrillation. Health Qual Life Outcomes 7: 65. DOI: 10.1186/1477–7525–7–65.

21. Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, et al. (2006). Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 27(8): 949–953. DOI: 10.1093/eurhe­artj/ehi825.

22. Hindricks G, Piorkowski C, Tanner H, Kobza R, Gerds-Li JH, Carbucicchio C, et al. (2005). Perception of atrial fibrillation before and after radiofrequency catheter ablation: relevance of asymptomatic arrhythmia recurrence. Circulation 112(3): 307–313. DOI: 10.1161/ CIRCULATIONAHA­.104.518837.

23. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. (2020). ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. DOI: 10.1093/ eurheartj/ehaa612.

24. Hohnloser SH, Kuck KH, Lilienthal J (2000). Rhythm or rate control in atrial fibrillation– Pharmacological Intervention in Atrial Fibrillation (PIAF): a randomised trial. Lancet 356(9244): 1789–1794. DOI: 10.1016/s0140–6736(00)03230-x.

25. Hsu LF, Jais P, Sanders P, Garrigue S, Hocini M, Sacher F, et al. (2004). Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med 351(23): 2373–2383. DOI: 10.1056/ NEJMoa041018.

26. Jenkins LS, Brodsky M, Schron E, Chung M, Rocco T, Jr., et al. (2005). Quality of life in atrial fibrillation: the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. Am Heart J 149(1): 112–120. DOI: 10.1016/j.ahj­.2004.03.065.

27. Kang Y, Bahler R. (2004). Health-related quality of life in patients newly diagnosed with atrial fibrillation. Eur J Cardiovasc Nurs 3(1): 71–76. DOI: 10.1016/j.ejcnur­se.2003.12.002.

28. Kannel WB, Wolf PA, Benjamin EJ, Levy D (1998). Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 82(8A): 2N–9N. DOI: 10.1016/s0002–9149(98)00583–9.

29. Kotecha D, Ahmed A, Calvert M, Lencioni M, Terwee CB, Lane DA (2016). Patient-Reported Outcomes for Quality of Life Assessment in Atrial Fibrillation: A Systematic Review of Measurement Properties. PLoS One 11(11): e0165790. DOI: 10.1371/journal­.pone.0165790.

30. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Ramachandran SV, et al. (2004). Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 110(9): 1042– 1046. DOI: 10.1161/01.CIR­.0000140263.20897­.42.

31. Lonnerholm S, Blomstrom P, Nilsson L, Oxelbark S, Jideus L, Blomström-Lundqvist C (2000). Effects of the maze operation on health-related quality of life in patients with atrial fibrillation. Circulation 101(22): 2607–2611. DOI: 10.1161/01.cir­.101.22.2607.

32. Mark DB, Anstrom KJ, Sheng S, Piccini JP, Baloch KN, Monahan KH, et al. (2019). Effect of Catheter Ablation vs Medical Therapy on Quality of Life among Patients with Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA 321(13): 1275–1285. DOI: 10.1001/jama.2019­.0692.

33. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, et al. (2006). Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 114(2): 119–125. DOI: 10.1161/ CIRCULATIONAHA­.105.595140.

34. Oral H, Pappone C, Chugh A, Good E, Bogun F, Pelosi F, Jr., et al. (2006). Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med 354(9): 934–941. DOI: 10.1056/ NEJMoa050955.

35. Pappone C, Rosanio S, Augello G, Gallus G, Vicedomini G, Mazzone P, et al. (2003). Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study. J Am Coll Cardiol 42(2): 185–197. DOI: 10.1016/s0735–1097(03)00577–1.

36. Paquette M, Roy D, Talajic M, Newman D, Couturier A, Yang C, et al. (2000). Role of gender and personality on quality-of-life impairment in intermittent atrial fibrillation. Am J Cardiol 86(7): 764–768. DOI: 10.1016/s0002–9149(00)01077–8.

37. Peinado R, Arribas F, Ormaetxe JM, Badia X (2010). Variation in quality of life with type of atrial fibrillation. Rev Esp Cardiol 63(12): 1402–1409. DOI: 10.1016/s1885–5857(10)70274–7.

38. Piccini JP, Hammill BG, Sinner MF, Jensen PN, Hernandez AF, Heckbert SR, et al. (2012). Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993– 2007. Circ Cardiovasc Qual Outcomes 5(1): 85–93. DOI: 10.1161/CIRCO­UTCOMES.111.962688.

39. Reynolds MR, Lavelle T, Essebag V, Cohen DJ, Zimetbaum P (2006). 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 152(6): 1097–1103. DOI: 10.1016/j.ahj­.2006.08.011.

40. Rienstra M, Lubitz SA, Mahida S, Magnani JW, Fontes JD, Sinner MF, et al. (2012). Symptoms and functional status of patients with atrial fibrillation: state of the art and future research opportunities. Circulation 125(23): 2933–2943. DOI: 10.1161/CIRCU­LATIONAHA.111­.069450.

41. Rienstra M, Van Veldhuisen DJ, Hagens VE, Ranchor AV, Veeger NJ, Crijns HJGM, et al. (2005). Gender-related differences in rhythm control treatment in persistent atrial fibrillation: data of the Rate Control Versus Electrical Cardioversion (RACE) study. J Am Coll Cardiol 46(7): 1298–1306. DOI: 10.1016/j.jac­c.2005.05.078.

42. Spertus J, Dorian P, Bubien R, Lewis S, Godejohn D, Reynolds MR, et al. (2011). Development and validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in patients with atrial fibrillation. Circ Arrhythm Electrophysiol 4(1): 15–25. DOI: 10.1161/CIRCEP­.110.958033.

43. Sud S, Massel D, Klein GJ, Leong-Sit P, Yee R, Skanes AC, et al. (2007). The expectation effect and cardiac pacing for refractory vasovagal syncope. Am J Med 120(1): 54–62. DOI: 10.1016/j. amjmed.2006.05.046.

44. Suman-Horduna I, Roy D, Frasure-Smith N, Talajic M, Lesperance F, Blondeau L, et al. (2013). Quality of life and functional capacity in patients with atrial fibrillation and congestive heart failure. J Am Coll Cardiol 61(4): 455–460. DOI: 10.1016/j.jac­c.2012.10.031.

45. Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HCW (2012). Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 21(4): 651–657. DOI: 10.1007/s11136–011–9960–1.

46. Thrall G, Lip GY, Carroll D, Lane D (2007). Depression, anxiety, and quality of life in patients with atrial fibrillation. Chest 132(4): 1259–1264. DOI: 10.1378/chest.07–0036.

47. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, et al. (2003). Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation 107(23): 2920–2925. DOI: 10.1161/01.CIR­.0000072767.89944­.6E.

48. Ware JE, Jr., Sherbourne CD (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6): 473–483. DOI: 10.1097/00005650– 199206000–00002.

49. Ware JE, Jr., Kosinski M, Keller SD (1996). A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3): 220–233. DOI: 10.1097/00005650–199603000–00003.

50. Wazni OM, Marrouche NF, Martin DO, Verma A, Bhargava M, Saliba W, et al. (2005). Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 293(21): 2634–2640. DOI: 10.1001/jama.293­.21.2634.

51. Weerasooriya R, Jais P, Hocini M, Scavee C, MacLe L, Hsu LF, et al. (2005). Effect of catheter ablation on quality of life of patients with paroxysmal atrial fibrillation. Heart Rhythm 2(6): 619–623. DOI: 10.1016/j.hrthm­.2005.02.1037.

52. Wynn GJ, Todd DM, Webber M, Bonnett L, McShane J, Kirchhof P, et al. (2014). The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification. Europace 16(7): 965–972. DOI: 10.1093/europa­ce/eut395.

53. Yamashita T, Kumagai K, Koretsune Y, Mitamura H, Okamura K, Ogawa S, et al. (2003). A new method for evaluating quality of life specific to patients with atrial fibrillation: Atrial Fibrillation Quality of Life Questionnaire (AFQLQ). Jpn J Electrocardiol 23(4): 332–343. DOI: 10.5105/ jse.23.332.