BACKGROUND: Atrial fibrillation (AF) significantly reduces health-related quality of life (HRQoL), previously measured in clinical trials using patient-reported outcomes (PROs). We examined AF PROs in clinical practice and their association with subsequent clinical management. METHODS: The Utah My Evaluation (mEVAL) program collects the Toronto AF Symptom Severity Scale (AFSS) in AF outpatients at the University of Utah. Baseline factors associated with worse AF symptom score (range 0-35, higher is worse) were identified in univariate and multivariable analyses. Secondary outcomes included AF burden and AF healthcare utilization. We also compared subsequent clinical management at 6 months between patients with better versus worse AF HRQoL. RESULTS: Overall, 1338 patients completed the AFSS symptom score, which varied by sex (mean 7.26 for males vs. 10.27 for females; p < .001), age (<65, 9.73; 65-74, 7.66; ≥75, 7.58; p < .001), heart failure (9.39 with HF vs. 7.67 without; p < .001), and prior ablation (7.28 with prior ablation vs. 8.84; p < .001). In multivariable analysis, younger age (mean difference 2.92 for <65 vs. ≥75; p < .001), female sex (mean difference 2.57; p < .001), pulmonary disease (mean difference 1.88; p < .001), and depression (mean difference 2.46; p < .001) were associated with higher scores. At 6-months, worse baseline symptom score was associated with the use of rhythm control (37.1% vs. 24.5%; p < .001). Similar cofactors and results were associated with increased AF burden and health care utilization scores. CONCLUSIONS: AF PROs in clinical practice identify highly-symptomatic patients, corroborating findings in more controlled, clinical trials. Increased AFSS score correlates with more aggressive clinical management, supporting the utility of disease-specific PROs guiding clinical practice.
BACKGROUND: Atrial fibrillation (AF) significantly reduces health-related quality of life (HRQoL), previously measured in clinical trials using patient-reported outcomes (PROs). We examined AF PROs in clinical practice and their association with subsequent clinical management. METHODS: The Utah My Evaluation (mEVAL) program collects the Toronto AF Symptom Severity Scale (AFSS) in AF outpatients at the University of Utah. Baseline factors associated with worse AF symptom score (range 0-35, higher is worse) were identified in univariate and multivariable analyses. Secondary outcomes included AF burden and AF healthcare utilization. We also compared subsequent clinical management at 6 months between patients with better versus worse AF HRQoL. RESULTS: Overall, 1338 patients completed the AFSS symptom score, which varied by sex (mean 7.26 for males vs. 10.27 for females; p < .001), age (<65, 9.73; 65-74, 7.66; ≥75, 7.58; p < .001), heart failure (9.39 with HF vs. 7.67 without; p < .001), and prior ablation (7.28 with prior ablation vs. 8.84; p < .001). In multivariable analysis, younger age (mean difference 2.92 for <65 vs. ≥75; p < .001), female sex (mean difference 2.57; p < .001), pulmonary disease (mean difference 1.88; p < .001), and depression (mean difference 2.46; p < .001) were associated with higher scores. At 6-months, worse baseline symptom score was associated with the use of rhythm control (37.1% vs. 24.5%; p < .001). Similar cofactors and results were associated with increased AF burden and health care utilization scores. CONCLUSIONS: AF PROs in clinical practice identify highly-symptomatic patients, corroborating findings in more controlled, clinical trials. Increased AFSS score correlates with more aggressive clinical management, supporting the utility of disease-specific PROs guiding clinical practice.
Authors: Jonathan P Piccini; DaJuanicia N Simon; Benjamin A Steinberg; Laine Thomas; Larry A Allen; Gregg C Fonarow; Bernard Gersh; Elaine Hylek; Peter R Kowey; James A Reiffel; Gerald V Naccarelli; Paul S Chan; John A Spertus; Eric D Peterson Journal: JAMA Cardiol Date: 2016-06-01 Impact factor: 14.676
Authors: Benjamin A Steinberg; Melissa A Greiner; Bradley G Hammill; Lesley H Curtis; Emelia J Benjamin; Susan R Heckbert; Jonathan P Piccini Journal: Cardiovasc Ther Date: 2015-08 Impact factor: 3.023
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Taylor C Bazemore; Lauren E Bolger; Samuel F Sears; Murrium I Sadaf; Anil K Gehi Journal: Pacing Clin Electrophysiol Date: 2018-12-27 Impact factor: 1.976
Authors: Ayman A Hussein; Bruce Lindsay; Ruth Madden; David Martin; Walid I Saliba; Khaldoun G Tarakji; Bilal Saqi; David J Rausch; Thomas Dresing; Thomas Callahan; Mina K Chung; Bryan Baranowski; Mandeep Bhargava; Daniel Cantillon; John Rickard; Mohamed Kanj; Patrick Tchou; Bruce L Wilkoff; Steven E Nissen; Oussama M Wazni Journal: Circ Arrhythm Electrophysiol Date: 2019-03
Authors: Josef Stehlik; Carlos Rodriguez-Correa; John A Spertus; Joshua Biber; Jose Nativi-Nicolau; Susan Zickmund; Benjamin A Steinberg; David C Peritz; Andrew Walker; Jordan Hess; Stavros G Drakos; Abdallah G Kfoury; James C Fang; Craig H Selzman; Rachel Hess Journal: J Card Fail Date: 2017-10-02 Impact factor: 5.712
Authors: Pamela J McCabe; Lynette G Stuart-Mullen; Christopher J McLeod; Thomas O Byrne; Monika M Schmidt; Megan E Branda; Joan M Griffin Journal: Patient Prefer Adherence Date: 2018-09-25 Impact factor: 2.711
Authors: Tyson S Burnham; Monte L Scott; Benjamin A Steinberg; Daniel L Varela; Brian Zenger; T Jared Bunch Journal: Arrhythm Electrophysiol Rev Date: 2021-10