Roopinder K Sandhu1, Marcie Smigorowsky2, Evan Lockwood3, Anamaria Savu4, Padma Kaul5, Finlay A McAlister6. 1. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: rsandhu2@ualberta.ca. 2. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada. 3. Division of Cardiology, Royal Alexandra Hospital, Edmonton, Alberta, Canada. 4. The Canadian VIGOUR Center, Edmonton, Alberta, Canada. 5. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; The Canadian VIGOUR Center, Edmonton, Alberta, Canada. 6. The Canadian VIGOUR Center, Edmonton, Alberta, Canada; Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: Despite being a common intervention to restore sinus rhythm in patients with atrial fibrillation (AF), limited data exist on the impact of electrical cardioversion on quality of life (QoL) outcomes in clinical practice. METHODS: This was a prospective cohort study of consecutive patients with AF referred for outpatient electrical cardioversion at 2 hospitals in Edmonton from 2013-2014. Baseline demographics, clinical characteristics, medications, and procedure details were obtained. QoL was assessed at baseline and at 3 months using the global Short-Form Health Survey (SF-36) and the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. RESULTS: One hundred patients underwent electrical cardioversion and completed follow-up. The median age was 62 years (interquartile range, 56-68 years) and 80% were men; the majority had nonparoxysmal AF (90%) with a mean left ventricular ejection fraction of 50.0% (± 12.4). At baseline, scores were lower than those reported from healthy individuals across all domains of the SF-36. The overall mean AFEQT score was 55.6 ± 24.4, and the domain-specific scores were as follows: symptoms, 66.2 ± 26.6; daily activities, 48.5 ± 29.5; treatment concerns, 57.6 ± 25.8; and treatment satisfaction, 56.7 ± 26.1. There were significant improvements in the vast majority of the SF-36 and AFEQT domains for the 51 patients who maintained sinus rhythm at 3 months. Patients who were in AF by 3 months demonstrated improvements in the AFEQT treatment concern score (P = 0.02) and SF-36 emotional role value (P < 0.01) compared with baseline values, which may be the result of treatment expectations related to cardioversion. CONCLUSIONS: There are significant QoL benefits for patients who maintain sinus rhythm after electrical cardioversion.
BACKGROUND: Despite being a common intervention to restore sinus rhythm in patients with atrial fibrillation (AF), limited data exist on the impact of electrical cardioversion on quality of life (QoL) outcomes in clinical practice. METHODS: This was a prospective cohort study of consecutive patients with AF referred for outpatient electrical cardioversion at 2 hospitals in Edmonton from 2013-2014. Baseline demographics, clinical characteristics, medications, and procedure details were obtained. QoL was assessed at baseline and at 3 months using the global Short-Form Health Survey (SF-36) and the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. RESULTS: One hundred patients underwent electrical cardioversion and completed follow-up. The median age was 62 years (interquartile range, 56-68 years) and 80% were men; the majority had nonparoxysmal AF (90%) with a mean left ventricular ejection fraction of 50.0% (± 12.4). At baseline, scores were lower than those reported from healthy individuals across all domains of the SF-36. The overall mean AFEQT score was 55.6 ± 24.4, and the domain-specific scores were as follows: symptoms, 66.2 ± 26.6; daily activities, 48.5 ± 29.5; treatment concerns, 57.6 ± 25.8; and treatment satisfaction, 56.7 ± 26.1. There were significant improvements in the vast majority of the SF-36 and AFEQT domains for the 51 patients who maintained sinus rhythm at 3 months. Patients who were in AF by 3 months demonstrated improvements in the AFEQT treatment concern score (P = 0.02) and SF-36 emotional role value (P < 0.01) compared with baseline values, which may be the result of treatment expectations related to cardioversion. CONCLUSIONS: There are significant QoL benefits for patients who maintain sinus rhythm after electrical cardioversion.