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Stempfel S, Aeschbacher S, Blum S, Meyre P, Gugganig R, Beer JH, Kobza R, Kühne M, Moschovitis G, Menghini G, Novak J, Osswald S, Rodondi N, Moutzouri E, Schwenkglenks M, Witassek F, Conen D, Sticherling C. Symptoms and quality of life in patients with coexistent atrial fibrillation and atrial flutter. IJC HEART & VASCULATURE 2020; 29:100556. [PMID: 32577496 PMCID: PMC7303549 DOI: 10.1016/j.ijcha.2020.100556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022]
Abstract
Aims Atrial fibrillation (AF) and atrial flutter (AFL) are two of the most common atrial arrhythmias and often coexist. Many patients with AF or AFL are symptomatic, which impacts their quality of life (QoL). The purpose of this study was to determine whether coexistent AFL represents an added burden for AF patients. Methods We combined baseline data from two large prospective, observational, multicenter cohort studies (BEAT-AF and Swiss-AF). All 3931 patients included in this analysis had documented AF. We obtained information on comorbidities, medication, and lifestyle factors. All participants had a clinical examination and a resting ECG. Symptom burden and QoL at the baseline examination were compared between patients with and without coexistent AFL using multivariable adjusted regression models. Results Overall, 809 (20.6%) patients had a history of AFL. Patients with coexistent AFL more often had history of heart failure (28% vs 23%, p = 0.01), coronary artery disease (30% vs 26%, p = 0.007), failed therapy with antiarrhythmic drugs (44% vs 29%, p < 0.001), and more often underwent AF-related interventions (36% vs 17%, p < 0.001). They were more often symptomatic (70% vs 66%, p = 0.04) and effort intolerant (OR: 1.14; 95% CI: 1.01-1.28; p = 0.04). Documented AFL on the baseline ECG was associated with more symptoms (OR: 2.30; 95% CI: 1.26-4.20; p = 0.007). Conclusion Our data indicates that patients with coexistent AF and AFL are more often symptomatic and report poorer quality of life compared to patients suffering from AF only.
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Affiliation(s)
- Samuel Stempfel
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Steffen Blum
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Pascal Meyre
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Rebecca Gugganig
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Jürg H Beer
- Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Switzerland
| | - Richard Kobza
- Department of Cardiology, Luzerner Kantonsspital, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | | | - Gianluca Menghini
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Jan Novak
- Department of Cardiology, Bürgerspital Solothurn, Switzerland
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland.,Department of General Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Elisavet Moutzouri
- Institute of Primary Health Care (BIHAM), University of Bern, Switzerland.,Department of General Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | | | - Fabienne Witassek
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland
| | - David Conen
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland.,Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Christian Sticherling
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland.,Cardiology Division, University Hospital Basel, University of Basel, Switzerland
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