Background and objective: In daily clinical practise, there is a lack of representative and robust data on the health-related quality of life (QoL) of patients with atrial fibrillation (AF).
Participants and method: In the non-interventional MOVE study, 638 physicians (predominantly cardiologists) in ambulatory care (78.0% of all centres) or hospital-based (12.7%), documented prospectively and retrospectively data from 3354 consecutive patients with ECG-confirmed AF in the previous 12 months (mean age 68.9 +/- 10.1 years; 62.4% males, mean CHADS (2) score 1.9 +/- 1.3). 1136 (33.9%) had paroxysmal, 899 (26.8%) persistent and 1295 (38.6%) permanent AF.
Results: Symptoms within the previous 4 weeks were present in 89.9% of the cases and 43.1% of the patients reported palpitations in the range from sometimes to very frequently. As treatment aim, physicians reported rate control in 64%, rhythm control in 8%, and both in 19% of the cases (not stated: 8%). In the University of Toronto Atrial Fibrillation Severity Scale (AFSS), emergency room attendance or hospitalizations for AF or associated diseases in the previous 12 months were reported in 24.2% or 30.8%, respectively. Rhythm control was associated with higher emergency room admittance or hospitalization rates, respectively. The EQ-5D index (0.94 points) was near the maximum of 1; thus this index does not appear to reflect QoL of AF patients adequately. Analyses of the Visual Analogue Scale (VAS) of the EuroQol (EQ-5D), and the assessment scale or specific questions of AFSS, respectively, indicated an intermediate QoL or disease burden, respectively. No or only small differences were documented between subgroups with different AF types, or subgroups treated according to different aims.
Conclusion: The great majority of AF patients had one or more recent AF symptoms, and their overall QoL was limited. In daily practise, rate control is not inferior to rhythm control in AF patients with respect to QoL.
Georg Thieme Verlag KG Stuttgart New York.