Clinical Outcomes of Rhythm Control Strategies for Asymptomatic Atrial Fibrillation According to the Quality of Life Score: A Comparison Study of Drugs for Symptom Control and Complication Prevention of Atrial Fibrillation (CODE-AF) Registry

2021 ◽  
Author(s):  
Ju Youn Kim ◽  
Hyoung-Seob Park ◽  
Hyung Wook Park ◽  
Eue-Keun Choi ◽  
Jin-Kyu Park ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Control Strategies ◽  
Symptom Control ◽  
Rhythm Control ◽  
Comparison Study ◽  
Life Score

scholarly journals Effects of Pharmacologic Therapy on Health-Related Quality of Life in Elderly patients with Atrial Fibrillation: A systematic Review of Randomized and Nonrandomized Trials

2013 ◽  
Vol 7 ◽  
pp. CMC.S10628 ◽  
Author(s):  
Carl J. Pepine
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Elderly Patients ◽  
Randomized Trials ◽  
Rhythm Control ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This systematic review assessed the impact of atrial fibrillation (AF) and pharmacotherapy on health-related quality of life (HRQOL) in elderly patients. Highly prevalent in the elderly, AF is associated with morbidity and symptoms affecting HRQOL. A PubMed and EMBASE search (1999-2010) was conducted using the terms atrial fibrillation, elderly, quality of life, Medicare, and Medicaid. In all, 504 articles were identified and 15 were selected (studies examining pharmacotherapy [rate or rhythm control] and HRQOL in AF patients with a mean age > 65 years). Information, including study design, cohort size, and HRQOL instruments utilized, was extracted. Five observational studies, 5 randomized trials comparing rate and rhythm control, 3 randomized trials investigating pharmacologic agents, and 2 trials examining HRQOL, depression, and anxiety were identified. Elderly AF patients had reduced HRQOL versus patients in normal sinus rhythm, particularly in domains related to physical functioning. HRQOL may be particularly affected in older AF patients. Although data do not indicate whether a pharmacologic intervention or single treatment strategy—namely rate versus rhythm control—is better at improving HRQOL, either of these strategies and many pharmacologic interventions may improve HRQOL in elderly AF patients. Based on reviewed data, an algorithm is suggested to optimize HRQOL among elderly patients.

scholarly journals Atrial fibrillation and clinical outcomes 1 to 3 years after myocardial infarction

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001726
Author(s):  
Anthony P Carnicelli ◽  
Ruth Owen ◽  
Stuart J Pocock ◽  
David B Brieger ◽  
Satoshi Yasuda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Oral Anticoagulants ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
History Of ◽  
The Impact

ObjectiveAtrial fibrillation (AF) and myocardial infarction (MI) are commonly comorbid and associated with adverse outcomes. Little is known about the impact of AF on quality of life and outcomes post-MI. We compared characteristics, quality of life and clinical outcomes in stable patients post-MI with/without AF.Methods/resultsThe prospective, international, observational TIGRIS (long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease) registry included 8406 patients aged ≥50 years with ≥1 atherothrombotic risk factor who were 1–3 years post-MI. Patient characteristics were summarised by history of AF. Quality of life was assessed at baseline using EQ-5D. Clinical outcomes over 2 years of follow-up were compared. History of AF was present in 702/8277 (8.5%) registry patients and incident AF was diagnosed in 244/7575 (3.2%) over 2 years. Those with AF were older and had more comorbidities than those without AF. After multivariable adjustment, patients with AF had lower self-reported quality-of-life scores (EQ-5D UK-weighted index, visual analogue scale, usual activities and pain/discomfort) than those without AF. CHA2DS2-VASc score ≥2 was present in 686/702 (97.7%) patients with AF, although only 348/702 (49.6%) were on oral anticoagulants at enrolment. Patients with AF had higher rates of all-cause hospitalisation (adjusted rate ratio 1.25 [1.06–1.46], p=0.008) over 2 years than those without AF, but similar rates of mortality.ConclusionsIn stable patients post-MI, those with AF were commonly undertreated with oral anticoagulants, had poorer quality of life and had increased risk of clinical outcomes than those without AF.Trial registration numberClinicalTrials: NCT01866904.

scholarly journals Subclinical and Asymptomatic Atrial Fibrillation: Current Evidence and Unsolved Questions in Clinical Practice

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 497
Author(s):  
Andrea Ballatore ◽  
Mario Matta ◽  
Andrea Saglietto ◽  
Paolo Desalvo ◽  
Pier Paolo Bocchino ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Control Strategies ◽  
Rhythm Control ◽  
Current Evidence ◽  
Individual Risk ◽  
Stroke Incidence ◽  
Asymptomatic Patients ◽  
Potential Benefits ◽  
Electrocardiogram Ecg

Atrial Fibrillation (AF) may be diagnosed due to symptoms, or it may be found as an incidental electrocardiogram (ECG) finding, or by implanted devices recordings in asymptomatic patients. While anticoagulation, according to individual risk profile, has proven definitely beneficial in terms of prognosis, rhythm control strategies only demonstrated consistent benefits in terms of quality of life. In fact, evidence collected by observational data showed significant benefits in terms of mortality, stroke incidence, and prevention of cognitive impairment for patients referred to AF catheter ablation compared to those medically treated, however randomized trials failed to confirm such results. The aims of this review are to summarize current evidence regarding the treatment specifically of subclinical and asymptomatic AF, to discuss potential benefits of rhythm control therapy, and to highlight unclear areas.

scholarly journals Cabins, castles, and constant hearts: rhythm control therapy in patients with atrial fibrillation

2019 ◽  
Vol 40 (46) ◽  
pp. 3793-3799c ◽  
Author(s):  
Stephan Willems ◽  
Christian Meyer ◽  
Joseph de Bono ◽  
Axel Brandes ◽  
Lars Eckardt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Left Ventricular Function ◽  
Antiarrhythmic Drugs ◽  
Left Ventricular ◽  
Rhythm Control ◽  
Af Ablation ◽  
Control Therapy

Abstract Recent innovations have the potential to improve rhythm control therapy in patients with atrial fibrillation (AF). Controlled trials provide new evidence on the effectiveness and safety of rhythm control therapy, particularly in patients with AF and heart failure. This review summarizes evidence supporting the use of rhythm control therapy in patients with AF for different outcomes, discusses implications for indications, and highlights remaining clinical gaps in evidence. Rhythm control therapy improves symptoms and quality of life in patients with symptomatic AF and can be safely delivered in elderly patients with comorbidities (mean age 70 years, 3–7% complications at 1 year). Atrial fibrillation ablation maintains sinus rhythm more effectively than antiarrhythmic drug therapy, but recurrent AF remains common, highlighting the need for better patient selection (precision medicine). Antiarrhythmic drugs remain effective after AF ablation, underpinning the synergistic mechanisms of action of AF ablation and antiarrhythmic drugs. Atrial fibrillation ablation appears to improve left ventricular function in a subset of patients with AF and heart failure. Data on the prognostic effect of rhythm control therapy are heterogeneous without a clear signal for either benefit or harm. Rhythm control therapy has acceptable safety and improves quality of life in patients with symptomatic AF, including in elderly populations with stroke risk factors. There is a clinical need to better stratify patients for rhythm control therapy. Further studies are needed to determine whether rhythm control therapy, and particularly AF ablation, improves left ventricular function and reduces AF-related complications.

scholarly journals Effect of rate or rhythm control on quality of life in persistent atrial fibrillation

2004 ◽  
Vol 43 (2) ◽  
pp. 241-247 ◽  
Author(s):  
Vincent E. Hagens ◽  
Adelita V. Ranchor ◽  
Eric Van Sonderen ◽  
Hans A. Bosker ◽  
Otto Kamp ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Rhythm Control
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