Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias

Abstract

BackgroundIn 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life.AimsTo conduct a qualitative cross sectional survey to understand patients’ perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM).MethodTwenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis.ResultsParticipants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information.ConclusionSymptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups.Trial registrationThe study is registered on the Clinical Trials website, Identifier NCT01672528

Patient perspectives of participating in the cardiac CopenHeartRFA rehabilitation program for patients treated with ablation for atrial fibrillation

“… 23 , 30 Previous studies reported that patients with AF felt their concerns were dismissed and undervalued by clinicians and did not receive guidance to help them cope with the emotional challenges of living with AF. 5 , 25 By contrast, in this study, with the support of the nurse, patients felt comfortable enough to discuss their fears, the meaning living with AF had for them, were able to look forward to achieving new goals, and see themselves as making progress toward those goals. Our findings are similar to Berg et al who conducted a rehabilitation trial including ICD patients.…”

“…However, the authors did not specify whether participants with AF reported those early benefits. 25 One quantitative study revealed that anxiety and depression decreased from baseline to 12 months after ablation treatment for paroxysmal AF. 26 Other than what we have documented in this study, little is known about participants’ psychological well-being earlier in recovery after the AF ablation procedure.…”

“…Consistent with findings in this study, some participants of qualitative studies have reported not wanting to burden family members by expressing feelings of depression or worry. 24 , 25 Others reported feeling unsupported, emotionally isolated, and misunderstood by family members and friends who could not grasp the effect of symptoms on their ability to function. 5 , 25 The findings demonstrate the need to generate deeper knowledge of how living with AF affects the psychological dynamics of family/partner relationships.…”

Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co‐production in an atrial fibrillation “learning café”

“…Inadequate patient and family support for coping with AF is common, due to insufficient disease knowledge and inadequate support in dealing with symptoms, which cause emotional distress . Fear and uncertainty can be reduced when health‐care providers have time to explain AF and to help patients self‐manage their AF .…”

Antiarrhythmic drugs use in elderly patients. Vaughan Williams class I and II drugs

“…), снижающих качество жиз-ни пожилых больных и приводящих к развитию трево-ги и депрессии [4,5]. Кроме того, аритмии могут клини-чески проявляться спутанностью сознания и необъясни-мыми падениями, которые у лиц пожилого возраста со-пряжены с повышенным риском переломов [6].…”