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Mood disorders, sex, age linked to inaccurate patient perception of AF burden
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Researchers for a new study identified mood disorders, sex and age as factors associated with inaccurate perception of prevailing rhythm in patients with atrial fibrillation.
Symptom relief is a primary goal for management of patients with AF, but if patients’ perception of their prevailing rhythm is inaccurate, treating symptoms can be difficult, according to the study background.
Anil K. Gehi
“Oftentimes, symptoms of AF can be difficult for patients to characterize. Some patients may have symptoms they think are due to AF, when in fact they may have another cause,” Anil K. Gehi, MD, FHRS, associate professor of medicine/cardiology at the University of North Carolina Center for Heart and Vascular Care, said in a press release. “Such misperceptions make it challenging to find appropriate and effective treatment options. Therefore, it is crucial for patients to learn to check their pulse, learn what’s normal vs. abnormal and truly understand their heart rhythm.”
Gehi and colleagues evaluated the accuracy of patient perception of prevailing rhythm in 458 patients with AF to identify factors that may predict inaccurate perceptions.
All patients had AF burden recorded by 1-week continuous heart monitors. They completed the AF Symptom Severity questionnaire, and as part of that exercise estimated the length and frequency of their AF episodes.
The researchers compared AF burden with patient reports and identified overestimators (those with AF burden < 10% who estimated that they had near-continuous AF) and underestimators (those with AF burden > 90% who estimated that they had little to no AF burden). They also performed multinomial logistic regression to identify predictors of overestimation and underestimation.
Approximately 15% of patients were classified as overestimators or underestimators. Of those, 33.8% were overestimators and 66.2% were underestimators.
Predictors of underestimation included older age (OR = 1.06; 95% CI, 1.01-1.1) and persistent AF (OR = 62.7; 95% CI, 6.94-565.9). In a bivariate analysis, female sex was predictive of underestimating (OR for male sex = 0.52; 95% CI, 0.28-0.97), but this was attenuated in a multivariate analysis (OR for male sex = 0.42; 95% CI, 0.15-1.17).
Predictors of overestimation included anxiety disorder (OR = 5.83; 95% CI, 1.88-18), depression disorder (OR = 3.38; 95% CI, 1.08-10.6) and lower mean heart rate (OR = 0.92; 95% CI, 0.87-0.98).
“Our study results reinforce the importance of bettering patient understanding of AF,” Gehi said in the release. “Improving communication with patients and educating them on the signs and symptoms of AF episodes could allow for a faster, more targeted treatment approach that would greatly enhance the quality of patient care.”
The researchers wrote that “heart monitoring could be useful to identify discrepancies between patient reports and prevailing rhythms, as it may provide a useful instantaneous symptom rhythm correlation for patients and their providers.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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