Heart Failure with Atrial Fibrillation: Physical Domain Severely Compromised Despite Preserved Mental Well-Being
DOI:
https://doi.org/10.12928/admj.v6i2.14418Keywords:
atrial fibrilation, chronic heart failure, quality of life, SF-36Abstract
Atrial fibrillation (AF) frequently coexists with chronic heart failure (CHF), imposing a “double chronic burden” that may severely affect patients’ quality of life (QoL). This study aimed to evaluate QoL in CHF patients with AF using the SF-36 questionnaire, focusing on the most impaired physical and mental domains. A descriptive study was conducted on 30 adult patients (≥40 years) attending the Cardiology Clinic of Mitra Medika Amplas Hospital, Medan. QoL was assessed using the validated Indonesian version of SF-36, and data were analyzed descriptively. The mean age was 62 years, with 70% female, 76.7% having non-valvular AF, and common comorbidities including coronary artery disease (43.3%) and hypertension (33.3%). Physical domains were severely impaired, with role physical (24.17), general health (37.00), and physical functioning (44.00), resulting in a low Physical Component Summary (PCS) of 30.0. In contrast, mental domains were relatively preserved, with mental health (80.93), vitality (80.17), and social functioning (76.35), yielding a Mental Component Summary (MCS) of 57.5. These findings indicate that CHF patients with AF experience substantial physical limitations despite maintained mental well-being, highlighting the importance of interventions targeting physical function while supporting psychosocial health.
References
Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024;45(36):3314-3414. doi:10.1093/eurheartj/ehae176
Lindberg T, Sanmartin Berglund J, Wimo A, Qiu C, Bohman DM, Elmståhl S. Prevalence of Atrial Fibrillation and Long-Term Survival of Older Adults; Findings from the SNAC Study. Gerontol Geriatr Med. 2024 Dec 3;10:23337214241304887. doi:10.1177/23337214241304887. PMID: 39628548; PMCID: PMC11613291.
Yuniadi, Y., Supit, A. I., Hanafy, D. A., et al. (2024). Prevalence of atrial fibrillation based on tertiary hospital survey in Indonesia: A smartphone-based diagnosis. Journal of Arrhythmia, 40(5), 1102–1107.
Hindricks, G., Potpara, T., Dagres, N., et al. (2021). 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). European Heart Journal, 42(5), 373–498.
Salim, S., Yamin, M., Alwi, I. (2017). Validity and reliability of the Indonesian version of SF-36 quality of life questionnaire on patients with permanent pacemakers. Acta Medica Indonesiana, 49(1), 10–16.
Salim, S., Setiati, S., Pudianto, A. P., et al. (2023). Validity and reliability studies of the Indonesian version of Atrial Fibrillation Severity Scale (AFSS). BMC Cardiovascular Disorders, 23, 216.
Zulmiyusrini, P., Yamin, M., Muhadi, M., et al. (2023). The validity and reliability of the Indonesian version of atrial fibrillation effect on quality of life (AFEQT) questionnaire for atrial fibrillation patients. Journal of Patient-Reported Outcomes, 7(1), 133.
Patel, R. B., Vaduganathan, M., Felker, G. M., et al. (2019). Physical activity, quality of life, and biomarkers in atrial fibrillation and heart failure with preserved ejection fraction (NEAT-HFpEF trial). American Journal of Cardiology, 123(10), 1660–1666.
AlTurki A, Andrade JG, Macle L, et al. Atrial fibrillation ablation for heart failure with preserved ejection fraction: A randomized controlled trial. Circulation. 2023;147(11):798-809.
Jiang Y, Wang Y, Chen G, et al. Quality of life and safety outcomes after first-line cryoablation versus antiarrhythmic drug therapy in atrial fibrillation: A meta-analysis of randomized controlled trials. Europace. 2024;26(3):456-65.
Lancini, D., Greenslade, J., Martin, P., et al. (2022). Chest pain workup in the presence of atrial fibrillation: impacts on troponin testing, myocardial infarction diagnoses, and long-term prognosis. European Heart Journal Acute Cardiovascular Care, 11(10), 772–781.
Zheng M, Xie Z, Shi X, Qu S. Mediating effect of coping strategy and psychological status between illness perception and quality of life among patients with atrial fibrillation: a cross-sectional study. BMC Cardiovasc Disord. 2024;24(1):504. doi:10.1186/s12872-024-04176-4
Lukman, N. A., Merry, L. (2023). Religion, support and self-care experiences: A qualitative descriptive study with Indonesian adults with chronic disease living in Montreal, Canada. Journal of Advanced Nursing, 79(5), 1765–1777.
Bang, M., Kim, H., Kim, J. (2023). Symptom clusters, anxiety and depression, and quality of life in patients with atrial fibrillation. Healthcare (Basel), 11(9), 1353.
Minjie, Y., Siyi, Z., Lin, H., et al. (2024). Illness perception, emotional symptoms, coping strategies and health-related quality of life in patients with atrial fibrillation. BMC Cardiovascular Disorders, 24, 4176.
Firdaus, Z. K. (2023). Religiusitas sebagai prediktor terhadap kesehatan mental: studi terhadap pemeluk agama Islam. Aisyah Journal of Intellectual Research in Islamic Studies, 3(2), 120–133.
García-Salazar LA, Latorre-Velásquez LA, Hernández N, et al. Atrial fibrillation and heart failure: Synergistic effect on functional class and quality of life. Rev Colomb Cardiol. 2024;31(4):393-401. doi:10.1016/j.rccar.2024.03.002
Suzuki S, Sagara K, Otsuka T, et al. Depression and quality of life in older adults with atrial fibrillation: A cross-sectional community-based study. J Cardiol. 2022;80(1):51-57. doi:10.1016/j.jjcc.2022.04.004
Kim, Y. G., Han, K. D., Choi, J. I., et al. (2016). Impact of radiofrequency catheter ablation on health-related quality of life and healthcare resource utilization in patients with atrial fibrillation. PLoS One, 11(10), e0163755.
Allan, K. S., Deyell, M. W., Andrade, J. G., et al. (2020). Catheter ablation for atrial fibrillation improves quality of life: a meta-analysis of randomized controlled trials. Canadian Journal of Cardiology, 36(11), 1765–1774.
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