Research LettersAssociation between symptoms, affect and heart rhythm in patients with persistent or paroxysmal atrial fibrillation: an ambulatory pilot study
Section snippets
Methods
We recruited thirty patients from Michigan Medicine outpatient electrophysiology clinics who were ≥18 years old and had a prior diagnosis of AF that was either paroxysmal or persistent. We collected demographic and medical data by reviewing medical charts in the electronic health record.
Symptom and affect data were collected using the MiAfib mobile application, which we have previously described in detail.4 The application prompted participants at regular intervals (9am, 12pm, 3pm, and 6pm) to
Results
Baseline and demographic data are shown in Table I. Thirty patients were included in the present analysis. Patients were older (mean age 66.1 years) and predominantly male (63%). All but two were on an AV-nodal blocker, and six were taking an antiarrhythmic medication.
Summary of the data collected on symptoms and affect from the MiAfib application are shown in Figure 1. Most symptom scores were right-skewed, with the most common response for each symptom being lack of that symptom. When
Discussion
In our analysis, we found that negative affect was strongly associated with a greater burden of symptoms in patients with AF, above and beyond the effects of positive affect and AF burden. The burden of AF over 24 hours prior to symptom assessment was associated with worse shortness of breath, palpitations and chest pain, but not dizziness/light-headedness and fatigue. Negative affect was more consistently associated with all of these symptoms relative to AF burden. Our study suggests that, in
Conclusion
In summary, we demonstrate that negative affect represents a strong predictor of severity of symptoms in patients with paroxysmal and persistent AF. The associations between emotions and perceptions of physical symptoms are complex and not well-understood; further research to better characterize this relation is warranted.
Funding
This work has been supported through K23 - HL13539703 career development grant.
Disclosures
Dr. Ghanbari has research support from National Institutes of Health and Toyota Corporation. Dr. Ghanbari serves as a consultant for Preventice and Verily Inc.
Acknowledgements
The Authors would like to thank Amanda Gomez for her help with manuscript preparation.
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