Modifiable risk factors, limiting symptoms, anxiety and high expectations regarding therapy are common in patients with paroxysmal/persistent atrial fibrillation

Abstract

Background Atrial fibrillation (AF) is the most common heart rhythm disorder, increases the risk for stroke and heart failure, and commonly impairs health related quality of life. Increasing evidence shows the causative role of several risk-factors and that aggressive lifestyle interventions might reduce AF and its impact. The size of the problem and how to provide optimal multi-disciplinary management is less well known. Purpose To screen for potentially amenable risk factors and describe how patients rate their symptom burden, well-being and expectations of future treatment. Methods The risk profile, symptom burden, well-being and expectations of future treatment were identified in 352 consecutive patients referred for possible cardioversion and visiting a specialist nurse at an AF outpatient clinic. Various questionnaires and instruments were used in addition to medical history, ECG recording, and height, weight, BMI calculation and blood pressure (BP) measurement. Results Altogether 69% had 1–5 possibly modifiable risk factors, 50% were overweight or obese, 39% had a BP >140/90 mmHg, 28% symptoms suggesting obstructive sleep apnoea and 25% reporterd no physical exercise. Respiratory distress during exertion was the most common symptom. Most patients had high expectations for their upcoming AF treatment, but men expected a full recovery more often than women (p=0.01). About 28% worried about their future health and reduced survival due to their AF. Conclusion Most of the patients with paroxysmal/persistent AF have risk factors suitable for life styles interventions. Many patients experience limitations in daily life, anxiety about their AF and worry about their future health and survival. Women and men also have different expectations of future care and treatment for recurrent AF. Funding Acknowledgement Type of funding source: None