Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

Abstract

Background Primary indication for catheter ablation of atrial fibrillation (AF) is to reduce symptoms and improve health‐related quality of life (HRQoL). There are data showing differences between the genders and between younger and older patients. To evaluate this, we studied a large Scandinavian cohort of patients referred for catheter ablation of AF. Methods Consecutive patients filled out the ASTA questionnaire, assessing symptoms, HRQoL, and perception of arrhythmia, prior to ablation. Patients were recruited from four Swedish and one Danish tertiary center. Results A total of 2493 patients (72% men) filled out the ASTA questionnaire. Women experienced eight of the nine ASTA scale symptoms more often than men. Patients <65 years reported four symptoms more often, only tiredness was more frequent in those ≥65 years (P = .007). Women and patients <65 years experienced more often palpitations and regarding close to fainting and this was more common among women, no age differences were seen. Women and men scored differently in 10 of the 13 HRQoL items. Only negative impact on sexual life was more common in men (P < .001). Older patients reported more negative influence in four of the HRQoL items and the younger in one; ability to concentrate. Conclusions Women experienced a more pronounced symptom burden and were more negatively affected in all HRQoL concerns, except for the negative impact on sexual life, where men reported more influence of AF. Differences between age groups were less pronounced. Disease‐specific patient‐reported outcomes measures (PROMs) add important information where gender differences should be considered in the care.

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

“…Our results are in line with studies of HRQoL in other areas of cardiovascular disease such as atrial fibrillation or ischemic heart disease, in which it has been suggested that the female gender is also associated with worse HRQoL [28][29][30]. However, it has not been clarified whether these differences are a real consequence of gender-related factors or whether they are related to a different presentation of the disease according to gender [30].…”

A Brazilian Portuguese translation, cultural adaptation and validation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) health-related quality of life (HRQOL) scale

“…The original Swedish validation provided similar results and the patient population was the same as in the present study, i.e., people with different forms of arrhythmia. Cronbach's alpha is sample-dependent and has also demonstrated sufficient reliability (Physical 0,86; Mental 0,75) in a large study evaluating symptoms and HRQOL in patients referred for catheter ablation due to AF, with values above the critical 0.70 level for the two ASTA-HRQOL scales [15,26,40].…”

Patients with symptomatic permanent atrial fibrillation show quantitative signs of pain sensitisation

“…20 Several studies have evaluated the relationship between patient characteristics and the presence of AF symptoms, and have found that asymptomatic AF is more frequent in men than in women, in older age and in patients with permanent AF. [20][21][22] Furthermore, episodes of asymptomatic AF are common even in highly symptomatic patients, and AF interventions such as AF ablation increase the proportion of asymptomatic to symptomatic AF episodes. 23 Symptoms of AF are highly variable in individual patients at different points in time, 20 which is confirmed in the present study by the significant change in AF6 sum scores for patients with symptomatic AF from roughly 6 months before the study to inclusion.…”