Clinical Research
Heart Rhythm Disorder
Quality of Life and Exercise Performance in Patients in Sinus Rhythm Versus Persistent Atrial Fibrillation: A Veterans Affairs Cooperative Studies Program Substudy

https://doi.org/10.1016/j.jacc.2006.03.051Get rights and content
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Objectives

The purpose of this study was to determine quality of life (QOL) and exercise performance (EP) in patients with persistent atrial fibrillation (AF) converted to sinus rhythm (SR) compared with those remaining in or reverting to AF.

Background

Restoration of SR in patients with AF improving QOL and EP remains controversial.

Methods

Patients with persistent AF were randomized double-blind to amiodarone, sotalol, or placebo. Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks (n = 624) and 1 year (n = 556). The QOL (SF-36), symptom checklist (SCL), specific activity scale (SAS), AF severity scale (AFSS), and EP were assessed.

Results

Favorable changes were seen in SR patients at 8 weeks in physical functioning (p < 0.001), physical role limitations (p = 0.03), general health (p = 0.002), and vitality (p < 0.001), and at 1 year in general health (p = 0.007) and social functioning (p = 0.02). Changes in the scores for SCL severity (p = 0.01), functional capacity (p = 0.003), and AFSS symptom burden (p < 0.001) at 8 weeks and in SCL severity (p < 0.01) and AF symptom burden (p < 0.001) at 1 year showed significant improvements in SR versus AF. Symptomatic patients were more likely to have improvement. The EP in SR versus AF was greater from baseline to 8 weeks (p = 0.01) and to 1 year (p = 0.02). The EP correlated with physical functioning and functional capacity except in the AF group at 1 year.

Conclusions

In patients with persistent AF, restoration and maintenance of SR was associated with improvements in QOL measures and EP. There was a strong correlation between QOL measures and EP.

Abbreviations and Acronyms

AF
atrial fibrillation
AFSS
atrial fibrillation severity scale
BMI
body mass index
EP
exercise performance
LAD
left atrial dimension
LVEF
left ventricular ejection fraction
QOL
quality of life
SAS
specific activity scale
SCL
symptom checklist
SR
sinus rhythm

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Supported by the Cooperative Studies Program of the Department of Veterans Affairs Office of Research and Development (Washington, DC), Berlex Laboratories, and Wyeth-Ayerst Laboratories.