Key result
The presence of any atrial fibrillation symptoms in older adults was associated with a higher likelihood of receiving rhythm control rather than rate control (OR 1.56; 95% CI 1.18-2.04).
Why the study?
In managing older adults with AF, symptomatology impacts well-being and may inform treatment decision-making, but symptom perception, QoL impact, and relation to treatment strategies warranted examination.
Observational (n=1,184)
Yes
Odds Ratio: 1.56 (95% CI 1.18–2.04)
In older adults with atrial fibrillation, non-specific symptoms are highly prevalent, and the presence of any AF symptoms is associated with a higher likelihood of receiving rhythm control therapy.
AF symptom presence was associated with rhythm control use; leaves open whether symptom-guided strategies improve outcomes in older adults.
BACKGROUND: In managing older adults with atrial fibrillation (AF), their symptomatology impacts their well-being and may inform treatment decision-making. We examined AF symptom perception, its impact on quality of life (QoL), and its relation to treatment strategies in older adults with AF. METHODS: Data were obtained from older adults with AF enrolled in a multicenter study conducted at clinic sites in Massachusetts and Georgia between 2016 and 2018. Participants were stratified into three age groups: 65-74 (youngest-old), 75-84 (middle-old), and ≥85 (oldest). Perception of AF symptoms was assessed by participant self-report during their clinic visit and at study enrollment by the Atrial Fibrillation Effect on Quality-of-Life Questionnaire which assessed cardiac-specific and non-specific, non-cardiac AF symptoms and their impact on QoL. Treatment strategies (rate or rhythm control) utilized were ascertained from electronic medical records. RESULTS: Among the 1184 participants (mean age 75 years, 48% women, 86% Non-Hispanic White), 51% were aged 65-74 years, 36% were 75-84 years, and 13% were ≥ 85 years. The most commonly reported AF symptoms were non-specific, non-cardiac symptoms (fatigue, dyspnea, lightheadedness) with similar prevalence and impact on QoL in all age groups. Cardiac-specific AF symptoms (palpitations, irregular heartbeat, pause in heart activity) were less prevalent, but most commonly reported by the youngest participants (65-74 years), who endorsed considerable impact of these symptoms on their QoL. Overall, those who reported experiencing any AF symptoms during their clinic visit were more likely to have received rhythm compared with rate control (OR: 1.56; 95% CI: 1.18-2.04) with similar findings for all age groups except those aged ≥85 years. CONCLUSIONS: Our findings suggest a high prevalence of non-specific, non-cardiac symptoms among older adults with AF and that cardiac-specific AF symptoms may exert considerable impact on their QoL. The presence of any AF symptoms may drive more rhythm control in a majority of older adults.
No takes yet. Share an insight, caveat, or question.
Abu et al. (2022) conducted an observational in Atrial fibrillation (n=1,184). Presence of any AF symptoms vs. Absence of AF symptoms was evaluated on Receipt of rhythm control compared with rate control (OR 1.56, 95% CI 1.18-2.04). The presence of any atrial fibrillation symptoms in older adults was associated with a higher likelihood of receiving rhythm control rather than rate control (OR 1.56; 95% CI 1.18-2.04).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: