Document Detail


Quality of life and functional capacity in patients with atrial fibrillation and congestive heart failure.
MedLine Citation:
PMID:  23265334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to assess the impact of rhythm- versus rate-control treatment strategies and of underlying rhythm on quality of life and functional capacity in patients with atrial fibrillation (AF) and congestive heart failure (CHF).
BACKGROUND: Although intention-to-treat and efficacy analyses have demonstrated similar cardiovascular outcomes in patients with AF and CHF randomized to rhythm or rate control, effects on quality of life remain to be determined.
METHODS: The AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial randomized 1,376 patients to rhythm- or rate-control strategies. For this pre-specified substudy, Medical Outcomes Short Form-36 questionnaires were administered at baseline and 4 months. Six-min walk tests were conducted at baseline, 3 weeks, 4 months, and 1 year.
RESULTS: Quality of life improved across all domains to a similar extent with rhythm and rate control. However, a higher proportion of time spent in sinus rhythm was associated with a modestly greater improvement in quality of life scores. Six-min walk distance (p = 0.2328) and New York Heart Association functional class (p = 0.1712) improved to a similar degree with rhythm and rate control. A higher proportion of time spent in sinus rhythm was associated with a greater improvement in New York Heart Association functional class (p < 0.0001) but not in 6-min walk distance (p = 0.1308).
CONCLUSIONS: Improvements in quality of life and functional capacity were similar in patients with AF and CHF randomized to rhythm- versus rate-control strategies. By contrast, sinus rhythm was associated with beneficial effects on New York Heart Association functional class and modest gains in quality of life. (Atrial Fibrillation and Congestive Heart Failure [AF-CHF]; NCT88597077).
Authors:
Irina Suman-Horduna; Denis Roy; Nancy Frasure-Smith; Mario Talajic; François Lespérance; Lucie Blondeau; Paul Dorian; Paul Khairy;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-12-19
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  61     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-25     Completed Date:  2013-04-03     Revised Date:  2013-07-10    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  455-60     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Montreal Heart Institute and Montreal Heart Institute Coordinating Center, Université de Montréal, Montreal, Quebec, Canada.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT88597077
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation* / etiology,  physiopathology,  psychology,  therapy
Electric Countershock / methods*
Exercise Tolerance / drug effects*
Female
Heart Failure* / complications,  diagnosis,  physiopathology,  psychology,  therapy
Heart Function Tests / drug effects,  methods,  statistics & numerical data
Heart Rate / drug effects
Humans
Male
Middle Aged
Multivariate Analysis
Organ Dysfunction Scores
Physical Fitness / psychology*
Quality of Life*
Questionnaires
Severity of Illness Index
Sickness Impact Profile
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2013 May 28;61(21):2196-7   [PMID:  23541968 ]
J Am Coll Cardiol. 2013 May 28;61(21):2197   [PMID:  23541966 ]
J Am Coll Cardiol. 2013 Jan 29;61(4):461-2   [PMID:  23265335 ]

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