Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation

Background The impact of atrial fibrillation (AF) and its treatment on health-related quality of life (QOL) is not well understood. We assessed QOL in patients with symptomatic AF participating in the Canadian Trial of Atrial Fibrillation. Methods Self-report QOL questionnaires including the Short-Form-36 (SF-36), symptom checklist (SCL) and AF Severity Scale (AFSS) were completed at baseline and 3, and 12 months after randomization. Results The study group was aged 65 ± 10 years and 59% were male. By design, 50% of patients were randomized to amiodarone (n = 132), 25% to sotalol (n = 66), and 25% to propafenone (n = 66). Most patients had normal left ventricular function (89%). Physical (41.9 ± 9.3 to 43.7 ± 9.2, P = .001) and mental health (47.5 ± 10.5 to 49.0 ± 9.8, P = .023) summary measures from the SF-36 improved significantly from baseline to 3 months. Arrhythmia symptom frequency and severity (SCL) also improved markedly from baseline to 3 months (symptom frequency 20.4 ± 9.4 to 16.2 ± 9.5 and symptom severity 16.7 ± 8.2 to 12.9 ± 7.4, both P < .001). QOL improvements were not significantly different among the groups randomized to amiodarone, sotalol, or propafenone. However, patients with no symptomatic recurrences of AF had higher scores at 3 months on measures of global well-being than those with recurrences in the first 3 months (7.4 ± 1.8 vs 6.9 ± 1.8, P < .05). There were no significant QOL changes from the 3 to 12 month assessment. Conclusion In patients with symptomatic AF, QOL improves after treatment, independent of the specific drug used for treatment. This is especially true for patients in whom treatment prevents AF recurrence. (Am Heart J 2002;143:984-90.)