Abstract 10102: Duration of Disease and the Quality of Life of the Patients with Atrial Fibrillation

Abstract

Introduction: Several recent studies have reported that early rhythm control for atrial fibrillation (AF) was associated with a lower risk of adverse cardiovascular outcomes than usual care. However, the effects of early intervention for AF on patients’ reported quality of life (QOL) in real-world patients, outside of selected clinical trials, have not been investigated. Methods: We analyzed 2,892 patients from a prospective, multicenter registry of consecutive AF patients (KiCS-AF) enrolled between 2012 to 2018 in Japan. Patients were divided into quartiles according to their AF duration (time interval between AF diagnosis and referral to the cardiology service; Q1 median 0 days [IQR:0-0], Q2 14 [7-22], Q3 119 [55-329], Q4 1968 [1122-3590]). The quartiles of AF duration were then compared with patients’ QOL improvement, as assessed by changes in the Atrial Fibrillation Effect on Quality-of-Life-overall summary score (AFEQ-OS [0 to 100]; higher score reflecting better QOL) over 1 year after the treatment initiation with analysis of covariance adjusted for differences in baseline characteristics. Results: Patients with the shortest duration of AF (Q1) were more likely to be older, female, and to have a higher incidence of heart failure compared with other groups. At 1 year, patients had improved AFEQT-OS scores, regardless of AF duration (adjusted difference [standard error], Q1, 8.2 [0.6], Q2 8.7 [0.6], Q3 8.7 [0.5], Q4 8.0 [0.5], p=0.67). The adjusted differences were similar in patients that underwent rhythm- (Q1 12.3 [0.7], Q2 12.2 [0.7], Q3 10.9 [0.7], Q4 12.2 [0.7], p=0.41) or rate-control strategy (Q1 3.3 [0.7], Q2 4.4 [0.8], Q3 4.5 [0.7], Q4 3.7 [0.8], p=0.64: Figure). Conclusions: The duration of AF was not associated with QOL improvement, regardless of treatment strategy. For symptomatic patients, the duration of AF should not be a deterrent to treatment.