Role of gender and personality on quality-of-life impairment in intermittent atrial fibrillation

Paquette, Miney; Roy, Denis; Talajic, Mario; Newman, David; Couturier, A.; Yang, Chang-Kook; Dorian, Paul

doi:10.1016/s0002-9149(00)01077-8

Cited by 150 publications

(108 citation statements)

References 25 publications

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“…The latter seems plausible if female patients are older and have more severe comorbidities than male patients. In Paquette et al's study [13], female patients were older and were more likely to have hypertension, but after these factors had been controlled, female patients still reported greater impairments in physical health and functional capacity than male patients.…”

Section: Introductionmentioning

confidence: 93%

“…Gender differences in QoL have been demonstrated and indicate that female patients report worse QoL relative to male patients [11][12][13][14][15]. Female patients are also more likely than male patients to report more AF-related complaints, such as greater frequency and severity of symptoms [13,15,16].…”

Section: Introductionmentioning

confidence: 99%

“…Female patients are also more likely than male patients to report more AF-related complaints, such as greater frequency and severity of symptoms [13,15,16]. However, it is unclear whether these discrepancies are a function of differential illness-reporting styles between genders, divergent illness evaluations, or whether female patients actually experience more frequent and severe AF symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…One set of factors that might be important to examine is psychological factors. To date, only one study has examined personality factors (i.e., somatization) that contribute to QoL differences between men and women with AF, yielding positive support for the role of nondisease variables [13]. Additional research is needed to identify psychosocial factors that may be associated with poorer QoL in female patients.…”

Section: Introductionmentioning

confidence: 99%

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Gender differences and quality of life in atrial fibrillation: The mediating role of depression

Ong

Irvine

Nolan

et al. 2006

Journal of Psychosomatic Research

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Objective: This study investigated gender differences, depression, and health-related quality of life (QoL) in a crosssectional sample of patients with atrial fibrillation (AF). Methods: This cross-sectional study involved a convenience sample of AF patients from two tertiary-care clinics in Toronto, Canada. Ninety-three AF patients completed psychometrically validated measures of generic QoL and depression. Mediation analyses evaluated the relationship between gender and QoL using depression as mediating variable. Results: Relative to male patients, female patients reported lower physical, but not mental, QoL. Gender was associated with both depression and physical QoL, while depression was correlated with poorer physical QoL. Path analyses demonstrated that depression significantly mediated the relationship between gender and physical QoL. Conclusion: Among AF patients, female patients report lower physical QoL relative to male patients, and this relationship may be mediated by self-reported symptoms of depression. Albeit correlational, the findings underscore the need to develop a better understanding of the role of depression in physical QoL, especially when considering the burden of AF in women. D

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gender differences and quality of life in atrial fibrillation: The mediating role of depression

Ong

Irvine

Nolan

et al. 2006

Journal of Psychosomatic Research

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“…10 The Canadian Trial of Atrial Fibrillation found that women had a more impaired quality of life as compared to men. 11 The risk of death in nonvalvular AF in the original Framingham cohort showed that AF was associated with an odds ratio for death of 1.5 in men and 1.9 in women. 12 The Copenhagen City Heart Study, which followed 29310 patients for 4.7 years, found AF to be independently associated with a higher cardiovascular mortality rate in women (hazard ratio [HR]: 4.4) as compared to men (HR: 2.2).…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Arrhythmias in Women

Curtis

Narasimha

2012

Clinical Cardiology

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There are important gender differences in cardiac electrophysiology that affect the epidemiology, presentation, and prognosis of various arrhythmias. Women have been noted to have higher resting heart rates compared to men. They also have a longer QT interval, which puts them at an increased risk for drug-induced torsades de pointes. Women with atrial fibrillation are at a higher risk of stroke, and they are less likely to receive anticoagulation and ablation procedures compared to men. Women have a lower risk of sudden cardiac death and are less likely to have known coronary artery disease at the time of an event compared to men. Both men and women have been shown to derive an equal survival benefit from implantable cardioverter defibrillators and cardiac resynchronization therapy, although these devices are significantly underutilized in women. Women also appear to have a better response to cardiac resynchronization therapy in terms of reduced numbers of hospitalizations and more robust reverse ventricular remodeling. Further studies are required to elucidate the underlying pathophysiology of these sex differences in cardiac arrhythmias. IntroductionSex differences in cardiac electrophysiology affect the epidemiology, presentation, and prognosis of various arrhythmias. These sex differences can have important clinical and therapeutic implications. Although the exact reason for these differences is not known, the potential mechanisms include differences in cardiac size, structure, and the different ways in which hormones, drugs, and electrolytes affect cardiac ion channels in men and women. The purpose of this review is to provide a synopsis of the important gender differences with respect to arrhythmias and to summarize updates from recent studies.

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Discerning the Incidence of Symptomatic and Asymptomatic Episodes of Atrial Fibrillation Before and After Catheter Ablation (DISCERN AF)

Verma

Champagne²,

Sapp³

et al. 2013

JAMA Intern Med

284

185

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Background: The DISCERN AF study (Discerning Symptomatic and Asymptomatic Episodes Pre and Post Radiofrequency Ablation of Atrial Fibrillation) monitored atrial fibrillation (AF) using an implantable cardiac monitor (ICM) to assess the incidence and predictors of asymptomatic AF before and after catheter ablation. Methods: Patients with symptomatic AF underwent implantation of an ICM with an automated AF detection algorithm 3 months before and 18 months after ablation. Patients kept a standardized diary to record symptoms of arrhythmia, and ICM data were downloaded every 3 months. All episodes were blindly adjudicated and correlated with the diary. Asymptomatic recurrences were ICM episodes of 2 minutes or longer with no associated diary symptoms. Results: Fifty patients had 2355 ICM episodes. Of these, 69.0% were true AF/atrial flutter (AFL)/atrial tachycardia (AT); 16.0%, sinus with extrasystoles; 11.0%, artifact; and 4.0%, sinus arrhythmia. Total AF/AFL/AT burden was reduced by 86% from a mean (SD) of 2.0 (0.5) h/d per patient before to 0.3 (0.2) h/d per patient after ablation (PϽ.001), and 56.0% of all episodes were asymp-tomatic. The ratio of asymptomatic to symptomatic AF episodes increased after ablation from 1.1 to 3.7 (P=.002). By symptoms alone, 29 of 50 patients (58%) were free of AF/AFL/AT after ablation compared with 23 of 50 (46%) using ICM-detected AF/AFL/AT recurrence. Asymptomatic episodes were more likely AFL/AT and were significantly shorter and slower, with lower heart rate variability. However, the postablation state was the strongest independent predictor of asymptomatic AF. Conclusions: The ratio of asymptomatic to symptomatic AF episodes increased from 1.1 before to 3.7 after ablation. Postablation state is the strongest predictor of asymptomatic AF. Symptoms alone underestimate postablation AF burden, with 12% of patients having asymptomatic recurrences only.

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Role of gender and personality on quality-of-life impairment in intermittent atrial fibrillation

Cited by 150 publications

References 25 publications

Gender differences and quality of life in atrial fibrillation: The mediating role of depression

Gender differences and quality of life in atrial fibrillation: The mediating role of depression

Arrhythmias in Women

Discerning the Incidence of Symptomatic and Asymptomatic Episodes of Atrial Fibrillation Before and After Catheter Ablation (DISCERN AF)

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