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A Prospective Randomized Multicenter Comparison on Health‐Related Quality of Life: The Value of Add‐On Arrhythmia Surgery in Patients with Paroxysmal, Permanent or Persistent Atrial Fibrillation Undergoing Valvular and/or Coronary Bypass Surgery
Author(s) -
VAN BREUGEL H. N. A. M.,
NIEMAN F. H. M.,
ACCORD R. E.,
VAN MASTRIGT G. A. P. G.,
NIJS J. F. M. A.,
SEVERENS J. L.,
VRAKKING R.,
MAESSEN J. G.
Publication year - 2010
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01655.x
Subject(s) - medicine , atrial fibrillation , quality of life (healthcare) , randomized controlled trial , cardiac surgery , cardiology , eq 5d , clinical endpoint , prospective cohort study , multicenter trial , multicenter study , health related quality of life , nursing , disease
Quality of Life After Add‐on Arrhythmia Surgery Introduction: This is a multicenter, prospective, randomized controlled trial to determine the effect of add‐on arrhythmia surgery on health‐related quality of life during 1‐year follow‐up of cardiac surgery patients with atrial fibrillation.Methods:150 patients with documented atrial fibrillation were randomly assigned to undergo cardiac surgery with or without add‐on surgery. Patients completed quality of life questionnaires, comprising the RAND 36‐item Health Survey 1.0 (SF‐36), Multidimensional Fatigue Inventory‐20 (MFI‐20) and EuroQoL (EQ‐5D and VAS) at baseline and 3, 6, and 12 months following operation.Results:132 patients completed the questionnaires at a minimum of one time‐point during follow‐up. At baseline patient characteristics, operative data and health‐related quality of life were comparable. At 12‐month follow‐up 62 patients were free of atrial fibrillation without significant differences between groups (P = 0.28). Conversion to SR occurred in 69.8% (37/53) of patients with paroxysmal AF, in 28.2% (11/39) of patients with permanent AF and in 44.4% (12/27) of patients in persistent AF. Cardiac surgery in general resulted in an overall improvement of the RAND SF‐36 and the MFI‐20. However, the EQ‐5D showed a significant deterioration in the subscale Pain/Discomfort for both groups (P < 0.001), with a significant worse outcome for the control group (P = 0.006).Conclusions:Health‐related quality of life in patients with paroxysmal, permanent and persistent atrial fibrillation improves after cardiac surgery regardless of giving add‐on surgery or not, but this improvement is presumably more affected by treating the underlying heart disease than by restoring sinus rhythm. (J Cardiovasc Electrophysiol, Vol. 21, pp. 511‐520, May 2010)