Original article Atrial fibrillation onset circumstances and their relation to patients’ quality of life

Abstract

Introduction: As assessed by patients, paroxysmal atrial fibrillation (AF) is very bothersome and significantly decreases quality of life (QoL). Aim: To learn the circumstances that patients attribute to the onset of episodes of paroxysmal AF and attempt to characterise the psychological importance of these situations and their influence on patients’ QoL. Methods: The study involved 76 patients (54 males, aged 17–74 years, mean 53.2), referred for ablation of paroxysmal AF. Disease duration ranged from 1 to 30 years, mean 8.3 years. Physical examination included searching for comorbidities and maximum ventricular rate during AF. Patients underwent psychological evaluation prior to ablation. The QoL was assessed with the SF-36v2 questionnaire. Questionnaire detailing the symptoms was also used. Results: Fifty-five (72%) patients were able to indicate situations accompanying onset of paroxysmal AF. From depicted situations cluster analysis distinguished three clusters: I – heavy meals, alcohol and coffee intake, exercise or stress; II – single sudden movement and rest following stressful events; III – sleep. Significant difference in QoL assessment was observed between these 3 groups. Patients in whom paroxysmal AF occurred after a single sudden movement and at rest find their QoL definitely the worst. The best QoL was in subjects with AF starting at night. Maximum ventricular rate during AF did not correlate with QoL in the whole study group; however, gender-matched analysis revealed significant correlation in females (r=–0.58; p=0.03). There was no significant correlation between other analysed variables and QoL. Conclusions: Objective indicators between patient health, such as disease duration or comorbidities, do not affect patients’ subjective assessment of QoL. Maximum ventricular rate during AF correlated with QoL only in females. Circumstances of AF event onsets, their relationship with disorganisation of activities and psychological value significantly influence QoL of the patients.