Health-related quality of life in atrial fibrillation patients over 65 years: A review

Atrial fibrillation is the most common sustained cardiac arrhythmia affecting 1-2% of the population; the prevalence of atrial fibrillation increases with ageing. The condition is associated with high morbidity and mortality, as well as reduced health-related quality of life, particularly in older people. A PubMed, CINAHL, EMBASE and CENTRAL search (January 2003 to April 2013) was conducted using the search terms atrial fibrillation, quality of life, health-related quality of life, older, aged, and over 65 years. In total, 572 papers were identified of which 15 were eligible, including three observational studies, five descriptive comparative studies and seven randomized control trials. Older atrial fibrillation patients (≥65 years) were significantly impaired in their health-related quality of life in both physical and mental domains compared to the general population or patients with sinus rhythm. Increasing age, being female or having severe symptoms resulted in poorer health-related quality of life particularly in the physical domain. The review also found that the current treatment of AF including rate and rhythm control strategies improved some aspects of health-related quality of life in atrial fibrillation patients but no specific strategy had a superior effect.