Gender, age and mood disorders affect how patients perceive atrial fibrillation symptoms


A new study shows how specific factors such as gender, age and mood disorders like anxiety and depression can lead patients with atrial fibrillation to inaccurately assess their heart rhythm.

The study, published in HeartRhythm, is the first-of-its-kind to evaluate demographics, health status and heart monitor data to identify specific factors that predict inaccuracies. Patients with persistent atrial fibrillation, women, older adults and those diagnosed with anxiety or depression were most likely to have inaccurate perceptions by either over-or-underestimating their atrial fibrillation symptoms.

Demographic and health status data were captured via questionnaires completed by 458 outpatients with documented atrial fibrillation. All patients wore continuous heart monitors for one week. Patients estimated the length and frequency of their atrial fibrillation episodes by completing the atrial fibrillation symptom severity questionnaire. Patient perceptions were compared to atrial fibrillation burden based on heart monitor results. Significant overestimators believed they were in near-continuous fibrillation when their burden was less than 10%, while significant underestimators believed they had little to no fibrillation when their burden was greater than 90%.

Fifteen per cent of patients were found to be significant over-or-underestimators. Psychological comorbidities specifically anxiety and depression strongly predicted overestimating (5%), with anxiety being the stronger correlate of the two. Participants with persistent atrial fibrillation, female and older adults (mean 72.5 years old) were more prone to underestimating (9.8%) the length and frequency of their episodes.

“Oftentimes symptoms of atrial fibrillation can be difficult for patients to characterise. Some patients may have symptoms they think are due to atrial fibrillation, when in fact they may have another cause. 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 is normal versus abnormal, and truly understand their heart rhythm,” stated co-lead author Anil Gehi, associate professor of Medicine/Cardiology, University of North Carolina Center for Heart and Vascular Care, USA. “Our study results reinforce the importance of bettering patient understanding of atrial fibrillation. Improving communication with patients and educating them on the signs and symptoms of episodes could allow for a faster, more targeted treatment approach that would greatly enhance the quality of patient care.”