Response to, "Atrial fibrillation and quality of life"

Thank you for your interest in our recent publication.1 We fully agree that atrial fibrillation is not a benign condition. However, its effect on health-related quality of life (HRQOL) can vary significantly from asymptomatic patients unaware of their arrhythmia to those whose symptoms are difficult to control despite optimal medical care. In this analysis of an older (mean age, 73 years) cohort undergoing pacemaker placement, atrial fibrillation was associated with a decrement in functional status as measured by the Specific Activity Scale but was not a major driver of overall HRQOL as measured by the SF-36. In this respect, our results are similar to those of the AFFIRM trial2 but are not necessarily generalizable to cohorts with different characteristics. Thus, we do not believe that the difference in atrial fibrillation seen between the 2 arms of the MOST trial fully explains the modest improvements in HRQOL seen with dual-chamber pacing.3