HRS: Atrial Fibrillation Affects Family as Much as Patient

By Crystal Phend
SAN FRANCISCO, 16 may 2008-- Living with someone with atrial fibrillation may be about as stressful as actually having the condition, researchers found.
While 28.6% of patients with atrial fibrillation felt a significant reduction in their quality of life, 31.2% of their mates reported the same, according to a survey reported at the Heart Rhythm Society meeting here.
Male spouses were as likely to be severely affected as female spouses, said Bruce A. Koplan, M.D., M.P.H., of Brigham and Women's Hospital in Boston, and colleagues.
While the shared stresses wouldn't affect the decision to treat a patient, it might play into how aggressively one chooses to treat AF, commented Richard L. Page, M.D., of the University of Washington in Seattle and program chair of the meeting.
One simple solution might be to make sure the spouse comes to office visits, particularly during the early visits around the time of diagnosis, Dr. Koplan said.
"Sometimes spouses come but stay in the waiting room," he said. "But I don't think that's a good idea because they're suffering too."
Educational programs and other interventions aimed at improving patients' quality of life should take spouses into account as well, Dr. Koplan said. Eliminating some of the unknowns may relieve the anxiety for both, he said.
"When you explain to patients about risks and options," he said, "it's probably as important to do that with their spouses as with them."
Although AF was known to lower quality of life among patients, Dr. Koplan's group wanted to find out how the family coped. They surveyed 260 patients and 94 spouses attending an educational symposium on living with AF.
The patients were typically men (60%) who had been diagnosed for more than a year (28.9% one to five and 58.6% more than five years) with persistent or permanent disease (53.1% and 23.2%, respectively).
Spouses were typically younger on average than patients (mean 62.5 versus 66.6, P=0.01).
The overall quality of life effects reported by these two groups did not differ significantly (P=0.55). Perceived impacts were:
Mild for 45.1% of patients and 43% of spouses
Moderate for 28.6% of patients versus 25.8% of spouses
Severe for 26.3% of patients and 31.2% of spouses
The same was true for the impact on their professional- or work-related quality of life (P=0.37) and sex life (P=0.93).
The lack of difference between groups persisted after adjustment for age and gender. All of the age subgroups showed a similar effect on quality of life between patients and spouses, as did the analysis comparing male and female spouses.
Dr. Koplan cautioned that the responses were self-reported and may have reflected selection bias if the spouses who attended the symposium were those who were more concerned than those who did not attend. Also, the findings could not rule out a difference in quality of life that might have been found by a larger study with more statistical power, he said.
Dr. Koplan reported being a consultant for and receiving speaker's honoraria from Medtronic, Boston Scientific, and St. Jude. Dr. Page reported being a paid consultant to sanofi-aventis.
Primary source: Heart Rhythm Society meetingSource reference:Koplan BA, et al "Living with atrial fibrillation: Does the spouse suffer as much as the patient?" HRS meeting 2008; Abstract PO1-151.