Clinical InvestigationElectrophysiologyInfluence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: The Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study
Section snippets
Study population
FRACTAL is an inception cohort study of patients with AF or flutter. Between May 1997 and June 2000, 1005 patients were enrolled at 17 centers in the United States and Canada after their first electrocardiographically confirmed episode. Atrial fibrillation occurring within 7 days of cardiac surgery was excluded. Patient management remained at the discretion of local practitioners. The study protocol was approved by the institutional committee on human research at each site, and patients
Results
Quality of life surveys were completed by 963 registry participants at enrollment. Baseline characteristics of this population, stratified by sex and by age older or younger than 65 years, are displayed in Table I.
The initial episode of AF either spontaneously converted to sinus rhythm or successfully treated with cardioversion in 926 (96%) patients. Atrial fibrillation was accepted as a permanent state from the outset in the other 37 patients. During the first year of follow-up, 10 more
Discussion
In this large inception cohort of newly diagnosed patients with AF, we found moderate symptom burden and reductions in both generic and disease-specific QoL at baseline, which normalized quickly after initial treatment and remained largely stable thereafter. Symptomatic recurrences of AF were relatively infrequent during early follow-up (22% at 1 year) in this population. Quality of life and symptom scores were therefore influenced less by the clinical course of AF than by comorbid illnesses
References (28)
- et al.
The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy
J Am Coll Cardiol
(2000) - et al.
Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation
Am Heart J
(2002) - et al.
Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study
J Am Coll Cardiol
(2003) - et al.
Role of gender and personality on quality-of-life impairment in intermittent atrial fibrillation
Am J Cardiol
(2000) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
Antithrombotic therapy in atrial fibrillation: the Seventh ACCP Conference on antithrombotic and thrombolytic therapy
Chest
(2004) - et al.
Effect of rate or rhythm control on quality of life in persistent atrial fibrillation. Results from the Rate Control versus Electrical Cardioversion (RACE) Study
J Am Coll Cardiol
(2004) - et al.
Gender-related differences in rhythm control treatment in persistent atrial fibrillation. Data of the Rate Control versus Electrical Cardioversion (RACE) study
J Am Coll Cardiol
(2005) - et al.
Effect of an implantable cardioverter defibrillator with atrial detection and shock therapies on patient-perceived, health-related quality of life
Am Heart J
(2003) - et al.
The influence of age, gender and race on the prevalence of depression in heart failure patients
J Am Coll Cardiol
(2004)
Significant gender-related differences in radiofrequency catheter ablation therapy
J Am Coll Cardiol
Asymptomatic atrial fibrillation in symptomatic patients
J Cardiovasc Electrophysiol
A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation
N Engl J Med
A comparison of rate control and rhythm control in patients with atrial fibrillation
N Engl J Med
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Financial support: FRACTAL has received financial support from Medtronic, Inc (Minneapolis, MN), and AstraZeneca (Wilmington, DE). Dr Reynolds is the recipient of grant K23HL077171 from the National Heart, Lung, and Blood Institute (NHLBI). Dr Essebag is the recipient of a Clinician Scientist Award from the Canadian Institutes of Health Research (CIHR).