Abstract
In patients with atrial fibrillation (AF), the restoration and maintenance of sinus rhythm is the primary therapeutic goal. Once sinus rhythm is maintained, physiological rate control is restored, and left ventricular ejection fraction, cardiac output, and exercise capacity are increased. This improved cardiovascular performance thereby enhances the patient's ability to perform the functions of normal daily life. The primary intervention for maintaining sinus rhythm after restoration is the use of anti-arrhythmic agents. Although physicians mostly use class 1A anti-arrhythmic drugs, these oral agents only maintain sinus rhythm in a limited number of cases and are accompanied by considerable side effects. Therefore, more effective tools are needed.
Effective treatment for AF is based on the above objective criteria, but subjective criteria such as the quality of life are growing in importance. To address these quality-of-life issues, we have initiated a prospective study in which patients are assigned to one of two groups: those with paroxysmal AF who are candidates for permanent implantable atrial defibrillators and those with chronic or paroxysmal AF who are not candidates for atrial defibrillators. Specifically designed questionnaires and various standardized and validated instruments are used to measure quality of life. The questionnaires cover social demographic data, including age, education, occupation level, driving behavior, return to work, and sexual activity.
Quality of life is a multidimensional construct, and thus its definition must consider the many factors mentioned above. In the final analysis, therefore, both objective and subjective criteria are necessary to define appropriate treatment of AF.
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References
Slevin ML. Quality of life: Philosophical question or clinical reality? Brit Med J 1992;305:466–469
Fitzpatrick R, Fletcher A, Gore S, et al. Quality of life measures in health care. I: Applications and issues in assessment. Brit Med J 1992;305:1074–1077
Fletcher A, Gore S, Jones D, et al. Quality of life in health care. II: Design, analysis, and interpretation. Brit Med J 1992;305:1145–1148
Spiegelhalter DJ, Gore SM, Fitzpatrick R, et al. Quality of life measures in health care. III: Resource allocation. Brit Med J 1992;305:1205–1209
Deister A. Vorhofflimmern-Entscheidungshilfen für die ambulante Therapie. Herz 1995;20 (Suppl III):4
Olschewski M, Schumacher M. “Lebensqualität” als Kriterium in der Therapieforschung. Intensivmed 1993;30:522–527.
Schumacher M, Olschewski M, Schulgen G. Assessment of quality of life in clinical trials. Stat Med 1991;10:1915–1930
Jung W, Deister A, Lüderitz B. Quality of life, psychological, and social aspects in patients with implantable cardioverter-defibrillators. In: Allessie MA, Fromer M, eds. Atrial and Ventricular Fibrillation: Mechanisms and Device Therapy. Armonk NY: Futura Publishing Co, Inc., 1997:311–320.
Bubien RS, Knotts-Dolson SM, Plumb VJ, Kay GN. Effect of radiofrequency catheter ablation on health-related quality of life and activities of daily living in patients with recurrent arrhythmias. Circulation 1996;94:1585–1591.
Testa M, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996;334:835–840
Hamer ME, Blumenthal JA, McCarthy EA, Phillips BG, Pritchett ELC. Quality-of-life assessment in patients with paroxysmal atrial fibrillation or paroxysmal supraventricular tachycardia. Am J Cardiol 1994;74:826–829
Lüderitz B, Jung W, Deister A, Marneros A, Manz M. Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias. PACE 1993;16:1815–1821
Lüderitz B, Jung W, Deister A, Manz M. Patient acceptance of implantable cardioverter defibrillator devices: Changing attitudes. Am Heart J 1994;127:1179–1184
Lüderitz B, Jung W, Deister A, Manz M. Quality of life in multiprogrammable implantable cardioverter-defibrillator recipients. In: Saksena S, Lüderitz B, eds. Textbook of Interventional Electrophysiology. Armonk, NY: Futura Publishing Company Inc., 1996:305–314.
Brignole M, Gianfranchi L, Menozzi C, et al. Influence of atrioventricular junction radiofrequency ablation in patients with chronic atrial fibrillation and flutter on quality of life and cardiac performance. Am J Cardiol 1994;74:242–246
Fitzpatrick AP, Kourouyan HD, Siu A, et al. Quality of life and outcomes after radiofrequency His-bundle catheter ablation and permanent pacemaker implantation: Impact of treatment in paroxysmal and established atrial fibrillation. Am Heart J 1996;131:499–507
Kay GN, Bubien RS, Epstein AE, Plumb VJ. Effect of catheter ablation of the atrioventricular junction on quality of life and exercise tolerance in paroxysmal atrial fibrillation. Am J Cardiol 1988;62:741–744
Crijns HJGM, Van Gelder IC, Tieleman, RG, Gosselink AT, Van den Berg MP. Why is atrial fibrillation bad for you? In: Murgatroyd FD, Camm AJ, eds. Non-pharmacological Management of Atrial Fibrillation. Armonk, NY: Futura Publishing Co., Inc., 1997:3–13
Lüderitz B, Jung W. Quality of life of patients with atrial fibrillation. In: Santini M, ed. Progress in Clinical Pacing. Armonk, NY: Futura Media Services, Inc; 1996:253–262
Jung W, Lüderitz B. Intraatrial defibrillation of atrial fibrillation. Z Kardiol 1996;85(Suppl 6):75–81
Jung W, Lüderitz B. Implantation of an arrhythmia management system for patients with ventricular and supraventricular tachyarrhythmias. Lancet 1997;349:853.
Jung W, Lüderitz B. Quality of life in patients with atrial fibrillation. J Cardiovasc Electrophysiol 1998;9(Suppl):S177-S186.
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Lüderitz, B., Jung, W. Quality of Life in Atrial Fibrillation. J Interv Card Electrophysiol 4 (Suppl 1), 201–209 (2000). https://doi.org/10.1023/A:1009823808552
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DOI: https://doi.org/10.1023/A:1009823808552