Quality of life in atrial fibrillation: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study

Ls, Jenkins; Brodsky, M; Schron, Eleanor B.; Chung, Mina K.; Rocco, Thomas P.; Lader, Ellis; Constantine, Michael; Sheppard, R. C.; Holmes, Da Juanicia N.; D, Mateski; Floden, Lysbeth; Prasun, Marilyn A.; Hl, Greene; Shemanski, Lynn

doi:10.1016/j.ahj.2004.03.065

Cited by 219 publications

(43 citation statements)

References 10 publications

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“…The largest of these, the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study [131], was powered to detect a difference in overall mortality, but showed no difference between a strategy of rhythm vs. rate control in the primary endpoint of all-cause mortality, with a slight trend toward better survival in the rate control arm. Secondary analyses demonstrated no differences in quality of life [136], although other sub-analyses demonstrated better mortality in patients in sinus rhythm or on warfarin [137], and a functional status sub-study demonstrated better NYHA functional class in the rhythm control arm and longer 6 minute walk test distances in patients in sinus rhythm [138]. …”

Section: Recommendations and Reasoningmentioning

confidence: 99%

2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

Frendl

Sodickson

Chung

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

258

253

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Section: Recommendations and Reasoningmentioning

confidence: 99%

2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

Frendl

Sodickson

Chung

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

258

253

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“…1, 4 The incremental cost related to AF in the US is estimated at $6–26 billion per year. 5 It is associated with reduced quality of life 6–8 and increased risk of stroke 9 and death. 10 Despite this overwhelming and growing health burden, it is striking that for decades, there has been essentially no change in the recommended initial clinical evaluation of patients with AF.…”

mentioning

confidence: 99%

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

et al. 2015

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Atrial disease or myopathy forms the substrate for atrial fibrillation (AF) and underlies the potential for atrial thrombus formation and subsequent stroke. Current diagnostic approaches in patients with AF focus on identifying clinical predictors with evaluation of left atrial size by echocardiography serving as the sole measure specifically evaluating the atrium. Although the atrial substrate underlying AF is likely developing for years prior to the onset of AF, there is no current evaluation to identify the pre-clinical atrial myopathy. Atrial fibrosis is one component of the atrial substrate that has garnered recent attention based on newer MRI techniques that have been applied to visualize atrial fibrosis in humans with prognostic implications regarding success of treatment. Advanced ECG signal processing, echocardiographic techniques, and MRI imaging of fibrosis and flow provide up-to-date approaches to evaluate the atrial myopathy underlying AF. While thromboembolic risk is currently defined by clinical scores, their predictive value is mediocre. Evaluation of stasis via imaging and biomarkers associated with thrombogenesis may provide enhanced approaches to assess risk for stroke in patients with AF. Better delineation of the atrial myopathy that serves as the substrate for AF and thromboembolic complications might improve treatment outcomes. Furthermore, better delineation of the pathophysiologic mechanisms underlying the development of the atrial substrate for AF, particularly in its earlier stages, could help identify blood and imaging biomarkers that could be useful to assess risk for developing new onset AF and suggest specific pathways that could be targeted for prevention.

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“…The results of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study [12] showed that there were no differences in survival or event rates in patients with AF randomized either to ventricular rate control or heart rhythm control. The QoL scores were comparable between the rate control and rhythm control interventions.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Circumferential Pulmonary Vein Isolation and Antiarrhythmic Drug Therapy in Patients with Atrial Fibrillation

Sharma

et al. 2012

Cardiol Ther

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IntroductionThe aim of this study was to evaluate quality of life after circumferential pulmonary vein isolation (CPVI) compared with antiarrhythmic drug therapy (ADT) in treating atrial fibrillation (AF). CPVI is now a common therapy in AF, but few studies have focused on the effect of CPVI on quality of life.MethodsA total of 123 AF patients were followed prospectively. Quality of life was evaluated comparing CPVI with ADT as a second-line treatment for patients with AF. The Medical Outcomes Study Short Form (SF)-36 health surveys were conducted to establish a baseline score before initiation and again at 6 months after the intervention.ResultsMean follow-up duration was 12.7 ± 4.3 months. Of 123 patients enrolled, 66 were randomized to receive CPVI and 57 to ADT alone. At the 6-month follow-up, 13 (22.8%) patients in the ADT group and 41 (62.1%) patients in the CPVI group had no recurrence of AF. The SF-36 scales were significantly higher in the CPVI than in the ADT group, as were the physical component summary scores (269.3 ± 58.6 vs. 234.9 ± 66.9) and mental component summary scores (273.6 ± 69.4 vs. 234.1 ± 44.7). Quality of life was significantly higher in the CPVI group (except for body pain).ConclusionIn patients with AF, CPVI has superiority over ADT with regards to the maintenance of sinus rhythm and improvements in quality of life.

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Quality of life in atrial fibrillation: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study

Cited by 219 publications

References 10 publications

2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

Comparison of Circumferential Pulmonary Vein Isolation and Antiarrhythmic Drug Therapy in Patients with Atrial Fibrillation

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