Atrial fibrillation and quality of life

Fleischmann et al have analyzed serial quality of life (QOL) measures using a Short Form-36, Specific Activity Scale, time trade-off in patients who had atrial fibrillation after pacemaker implantation.1 They have also concluded that in elderly patients, AF was not a major determinant of QOL. Authors argue that previous studies were small in size and used of invalidated measures to determine the QOL.2, 3 However, the major reason for treating patients with AF is to reduce the frequency of AF and also to decrease the disabling symptoms associated with its severity. There is documentation that QOL of patients with AF is poor compared not only to healthy individuals but also to patients with coronary artery disease.4 The odds ratio for total mortality in Framingham population after adjusting for age, heart disease, and various risk factors was 1.5 and 1.9 for male and female.5 Thus, AF is not a benign condition, and we need robust studies using a large population using well-validated measures like the one used by the authors for determining the burden of AF.