What affects the acceptance of illness in patients with atrial fibrillation?

Abstract Funding Acknowledgements Type of funding sources: None. Background. Patients with atrial fibrillation (AF) have symptoms that require advanced treatment. The most common include palpitations, dyspnea, dizziness, tiredness, chest pain and anxiety. Both the symptoms and treatment and its complications adversely affect the perception of the disease among patients with AF. The research proves that acceptance of illness (AIS) is a factor positively influencing the quality of life, but also the adaptation to the therapeutic recommendations of patients with chronic diseases. There is little research on factors increasing the level of AIS among patients with AF. The aim of the study is to determine the level of acceptance of illness in patients with AF and factors influencing the level of acceptance of illness. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess disease acceptance and International Physical Activity Questionnaire (IPAQ) to assess physical activity. Sociodemographic and clinical data were taken from the hospital register. Results. In the study group the average result of acceptance of illness (AIS) was 27.67 ± 7.70. 48.8% of patients had a high degree of disease acceptance, 38.09% average, and 13.11% had no acceptance. The examined patients showed a lack of physical activity (IPAQ = 0.92 ± 0.40). In comparative analyses women had lower level of AIS than men (27.36 ± 7.37 vs. 27.86 ± 7.97; p = 0.01), patients more often hospitalized due to AF lower than patients less frequently hospitalized (26.30 ± 6.11 vs. 30.55 ± 8.55; p = 0.02). Lower level of AIS was observed in patients with comorbidities (34 ± 6.25 vs. 22 ± 6.66; p < 0.001). Smokers had higher level of AIS than non-smokers (28.66 ± 6.65 vs. 27.00 ± 7.56; p = 0.02), similarly, physically active persons than inactive ones (26.48 ± 8.27 vs. 23.07 ± 10.58; p = 0.01). In correlation analysis, physical activity turned out to be an important determinant having a positive effect on the level of AIS (r = 0.220; p = 0.03). Conclusions. Patients with AF have moderate level of acceptance of illness and low level of physical activity. A higher level of AIS is observed in men, without comorbidities, less frequently hospitalized and smokers. The important determinant having positive influence on AIS is physical activity.

Download Full-text

The impact of the acceptance of illness on the quality of life of patients with atrial fibrillation

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab060.002 ◽

2021 ◽

Vol 20 (Supplement_1) ◽

Author(s):

B Jankowska-Polanska ◽

D Kasperczak ◽

N Swiatoniowska-Lonc ◽

J Polanski

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Heart Rhythm ◽

Well Being ◽

Supraventricular Arrhythmia ◽

Heart Rhythm Disorders ◽

The Mean ◽

Acceptance Of Illness ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. AF and the complications associated with it interfere with the physical, mental and social well-being of a person, thus affecting the quality of life. An important factor affecting the quality of life of patients with AF is the acceptance of illness (AI). In spite of the large problem related to this subject, the analysis of the relation between the acceptance of illness and the quality of life of patients with AF is insufficient. The aim of the study was to assess the impact of the acceptance of illness on the quality of life of patients with AF. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess the acceptance of illness and Arrhythmia-Specific questionnaire In Tachycardia and Arrhythmia (ASTA) to assess quality of life. Results. The majority of patients were secondary educated (64.27%), lived in a city (78.58%), were inactive (57.15%), were hospitalized 3-5 times (42.85%), had a cardiostimulator (23.80%) or underwent ablation (22.62%) during the last year. The average result of the acceptance of illness was 27.67 ± 7.70. 48.8% of patients had a high level of the acceptance of illness, 38.09% average, and 13.11% did not accept their illness. The mean result of quality of life for the whole studied group was (ASTA III) 25.64 ± 8.64. As regards the severity of symptoms (ASTA II) the mean result was 17.15 ± 5.89. Correlation analysis showed that the higher the level of the acceptance of illness the higher the quality of life (r = 0.640; p = 0.002) and lower the severity of AF symptoms (r=-0.51, p < 0.001). Conclusions. Patients with AF present a moderate level of disease acceptance and quality of life. The acceptance of illnessis the independent predictor and significantly increases quality of life of patients with AF.

Download Full-text

Cardiorespiratory fitness and electroanatomical remodelling in patients with atrial fibrillation

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.458 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

RS Mishima ◽

AD Elliott ◽

JP Ariyaratnam ◽

D Jones ◽

O Nguyen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiorespiratory Fitness ◽

De Novo ◽

Low Voltage ◽

Heart Rhythm ◽

Funding Sources ◽

Metabolic Equivalents ◽

Heart Rhythm Disorders ◽

Arrhythmogenic Substrate ◽

Conduction Velocities

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation (AF) is the most common clinically-relevant arrhythmia. Its initiation and maintenance is linked to the presence cardiovascular risk factors such as hypertension and obesity. Higher cardiorespiratory fitness (CRF) has been associated with a better prognosis. However, specific electroanatomical features associated with baseline CRF have not been described. Purpose Compare electroanatomical substrate across exercise capacity levels in patients with AF Methods Patients referred for de novo AF radiofrequency ablation at the Centre for Heart Rhythm Disorders from August 2017 until June 2020 were screened for inclusion and CRF was evaluated in metabolic equivalents (METs) by a symptom-limited maximal treadmill exercise test using the standard Bruce protocol prior to ablation. Predicted CRF was calculated based on established equations and patients were categorized according to the percentage of predicted CRF achieved; low (<85%), adequate (85-100%) and high (>100%). Total mean and regional peak-to-peak bipolar voltages, percent of low voltage areas (% LVA), conduction velocity (CV) and percent of complex fractionated electrograms (% CFE) in sinus rhythm were compared across groups. Results There were no between-group differences in baseline characteristics, medication use or echocardiographic features. Total mean voltage was significantly lower in the low CRF group compared to both adequate and high CRF. Compared to the high CRF group, roof (3.25 ± 1.2 mV vs 1.9 ± 1.3 mV, p < 0.05), posterior (3.8 ± 1.8 mV vs 1.7 ± 0.9 mV, p < 0.001) and inferior mean voltages (3.4 ± 2 mV vs 1.6 ± 0.7 mV, p < 0.05) were significantly lower in the low CRF group (figure 1A). Furthermore, compared with the adequate CRF group, mean voltages were significantly lower in the posterior (3.7 ± 1.5 mV vs 1.7 ± 0.9 mV, p < 0.001), inferior (3.4 ± 1 mV vs 1.6 ± 0.7 mV, p < 0.001) and lateral (4.2 ± 2.2 mV vs 2.1 ± 1.4 mV, p < 0.05) walls of the low CRF group. Anterior and septal mean voltages were not significantly different across CRF groups (P for trend = 0.07, 0.3 and 0.15, respectively). Conduction velocities were not significantly different across groups. The inferior %LVA was significantly higher in the low CRF (5.6 ± 6%) compared to adequate CRF group (23 ± 18%) (p < 0.05) (figure 1B). Total and regional % CFE was higher in the low CRF compared to adequate and high CRF. Conclusion Participants in the lower baseline CRF category showed significant reductions in regional voltages along with higher fractionation with preserved conduction velocities. Research on the effect of physical activity and CRF on left atrial arrhythmogenic substrate is required. Abstract Figure. Global and regional mV and % LVA by CRF

Download Full-text

A comparison of over-the-counter available smartwatches and devices for electrocardiogram based detection of atrial fibrillation

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab104.3047 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

J Scholten ◽

A Mahes ◽

J R De Groot ◽

M M Winter ◽

A H Zwinderman ◽

...

Keyword(s):

Atrial Fibrillation ◽

Atrial Flutter ◽

Heart Rhythm ◽

Detection Algorithm ◽

Left Knee ◽

Funding Sources ◽

Cardiology Department ◽

Normal Heart Rate ◽

Golden Standard ◽

Sensitivity Specificity

Abstract Background There is an increasing number of smartwatches and devices commercially available that can generate and automatically interpret an electrocardiogram (ECG). Such devices have an enormous potential to improve population screening and telemonitoring of atrial fibrillation (AF). Purpose There is limited data on the sensitivity, specificity and interpretability of these devices and comparative studies are lacking. Our purpose was to compare three frequently used devices for AF detection. Methods We performed a single-center, prospective study in consecutive patients with AF presenting for electrical cardioversion (ECV). We collected a standard 12-lead ECG recording immediately followed by four times 30 seconds of ECG recordings from different devices for every patient prior to the ECV. These paired measurements were considered simultaneous. If the ECV was performed, the same measurements were repeated afterwards. The standard 12L-ECGs were interpreted by a cardiologist and used as golden standard for heart rhythm. The different devices used for the 30 second ECGs were: Withings Move ECG (lead I), Apple Watch series 5 (lead I), Kardia Mobile 6L (six leads) and Withings/Apple (1:1 ratio) on left knee (lead II). Sensitivity and specificity were determined for each AF detection algorithm excluding patients with atrial flutter (AFL) or uninterpretable ECGs. In addition, proportions of uninterpretable ECGs were determined including all patients and including only patients with sinus rhythm (SR) and compared between devices using McNemar's test. Results A total of 220 patients were included (age 70±10 years, female 35%, first ECV 44%) and in total 415 12-lead ECGs were performed (45% SR, 45% AF, 10% AFL). The sensitivity/specificity were overall similar for all devices (Withings 98%/95%, Apple 94%/98%, Kardia 99%/91%. P>0.05 for all). In detail, Kardia was the most sensitive test with highest proportion of suspected AF (57%) whereas Apple was the most specific, as shown by the highest proportion of normal heart rate results by the device (55%, P=0.003 compared to Kardia (43%)). Overall, Withings, Apple and Kardia had a comparable proportion of uninterpretable ECGs (20%, 20%, 24%, respectively. P>0.05 for all). Lead II had higher proportion of uninterpretable ECGs (32%, p<0.01 compared to all). More specifically, Kardia had a higher rate of uninterpretable ECGs in those with SR (P<0.05 compared to Withings (lead I) and Apple (lead I)). Conclusion In all devices, we found sensitivity/specificity for AF detection between 91%-99%, better than previous studies reported, and 20–24% of uninterpretable ECGs. Kardia was the most sensitive device, but less useful to rule out atrial fibrillation whereas Apple had numerically highest specificity. We aim to further evaluate both cardiologist interpretation and accuracy of atrial flutter detection using different leads to inform clinical use. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Tergooi Cardiology department, J.P. Bokma was supported with a research grant by Amsterdam Cardiovascular Sciences Overview and comparison

Download Full-text

Physically Active Breaks in the Teaching Process

Collegium Antropologicum ◽

10.5671/ca.45.3.7 ◽

2021 ◽

Vol 45 (3) ◽

pp. 235-242

Author(s):

Ivan Holik ◽

Vesna Štemberger ◽

Petra Pejić Papak ◽

Vilko Petrić ◽

Matea Kitak

Keyword(s):

Physical Activity ◽

Educational Achievement ◽

Positive Influence ◽

Educational Process ◽

T Test ◽

Control Group ◽

Teaching Process ◽

Physically Active ◽

Active Breaks ◽

The Impact

The aim of this research is to study the impact of physically active breaks, accompanied by video materials, on the level of pupils’ educational achievement and their attitudes toward physically active breaks during the teaching process in the classroom. The research lasted for two months, and the apposite sample consisted of a total of 38 pupils aged 10 to 11. The influence of physically active breaks on the educational achievement was estimated by the percentage of correct answers in the tasks of mathematics, while the Croatian version of the questionnaire Attitudes towards the Physical Activity Scale (APAS) was used for evaluating the attitudes toward physically active breaks with video materials. Differ ences between the initial and final measuring inside the same group were tested by the Student’s dependent sample t-test, while for differences between the experimental and control group the Student’s independent sample t-test was used. The obtained results showed that the ability to solve mathematical tasks in the experimental group has significantly improved when compared to the control one and that physically active breaks have a positive influence on the pupils’ attitudes toward physical activity. The implementation of physically active breaks into teaching has an impact on pupils’ productivity in the educational process, while at the same time their need for movement is fulfilled.

Download Full-text

HAS-BLED scor system for the assessment of risk of breathing of patients on oral anticoagulant therapy // HAS-BLED skor sistem bodovanja za procjenu rizika od krvarenja pacijenata na oralnoj antikoagulantnoj terapiji

SESTRINSKI ŽURNAL ◽

10.7251/sez0118011d ◽

2018 ◽

Vol 5 (1) ◽

pp. 11

Author(s):

Daniela Dobrovoljski

Keyword(s):

Atrial Fibrillation ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Heart Rhythm ◽

Clinical Problem ◽

Coagulation Factors ◽

Heart Rhythm Disorders ◽

Anticoagulant Drugs

Oral anticoagulant drugs (OALs) are effective agents in the prevention and treatment of thromboembolic complications. However, despite standardization and application progression, OALs represent a significant clinical problem because they are small-therapeutic medicines that easily interact with food and medicine, which can substantially affect the increased or weakened therapeutic effect. Oral anticoagulants are 4-hydroxycoumarin derivatives and vitamin K antagonists, and their pharmacological activity is based on inhibition of the synthesis of coagulation factors in the liver. These drugs are effective in the prevention of venous thromboembolism, acute myocardial infarction (AIM), heart rhythm disorders by type of atrial fibrillation, stroke prevention, and the like. The most important and clinically commonly undesirable effect of OAL is bleeding. The risk of bleeding is greatest during the introduction of the drug in therapy and for the first few months of the onset of therapy. HAS-BLED scor is a skoring system developed to estimate the 1-year risk of major bleeding in patients with atrial fibrillation and is also used for other indications.

Download Full-text

Problem of prescribing anticoagulant therapy in patients with atrial fibrillation on the regional level

Medical Council ◽

10.21518/2079-701x-2020-11-19-25 ◽

2020 ◽

pp. 19-25

Author(s):

M. G. Nazarkina ◽

V. V. Stolyarova ◽

D. A. Karpova

Keyword(s):

Atrial Fibrillation ◽

Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Significant Proportion ◽

Heart Rhythm ◽

Regional Level ◽

Thromboembolic Complications ◽

Constant Form ◽

Heart Rhythm Disorders ◽

The Republic

Introduction. Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, with heart rhythm disorders accounting for a significant proportion of them. Atrial fibrillation (AF) is an arrhythmia that poses a risk of thromboembolic complications and is difficult to treat with ongoing preventive anticoagulant therapy. Aim of the study. To analyze the prescription of anticoagulant therapy to patients with AF on the regional level. Methods and results. The study included 72 patients with the nonvalvular form of AF (from 41 to 82 years old) of the Department of Rhythm and Conductivity Abnormalities of the State Budgetary Institution of the Republic of Mordovia RCH № 4 for 2019. Three groups were singled out depending on the AF form: the first one – patients with the constant form (n = 22), the second one (n = 24) – with the persistent form, the third one (n = 24) – with the paroxysmal form. The risk of thromboembolic complications was assessed using the CHA2DS2-VASc scale and hemorrhagic complications using the HAS-BLED scale. All patients had a high risk of thromboembolism (index above 2 points), which reflects multiple risk factors and indicates the need for oral anticoagulants (OAC). According to HAS-BLED scale calculations, the risk of haemorrhagic complications was low in most patients (2 or less points) – there was no significant increase in the risk of bleeding, but careful monitoring is required. Analysis of the results revealed that only 54% of patients took OAC, despite the fact that all patients were shown anticoagulant therapy. When analyzing the cases of patients who did not take anticoagulants, it was found that 23% of patients, despite the doctor’s recommendations, refused to take the drugs, 47% of patients justified the inability to control IHR and 30% were unable to purchase expensive new OAC. Conclusion. Despite the recommendations for the management of patients with atrial fibrillation, only 54% were prescribed oral anticoagulants.

Download Full-text

Apelin and Atrial Fibrillation: The Role in the Arrhythmia Recurrence Prognosis

Disease Markers ◽

10.1155/2018/5285392 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Agata Salska ◽

Michał Dziuba ◽

Witold Salski ◽

Krzysztof Chizynski ◽

Marzenna Zielinska

Keyword(s):

Atrial Fibrillation ◽

Heart Rhythm ◽

Persistent Atrial Fibrillation ◽

Enzyme Linked Immunosorbent Assay ◽

Direct Current Cardioversion ◽

Heart Rhythm Disorders ◽

Cardiology Clinic ◽

Clinic Medical ◽

Medical University

Apelin is a novel peptide of wide expression and multiple biological functions including the crucial role in cardiovascular homeostasis. The apelin role in the pathophysiology of heart rhythm disorders is considered, although the reports are scarce so far. The purpose of this study is to investigate the potential utility of apelin as a marker of arrhythmia recurrence after direct-current cardioversion (DC). The prospective, observational study included 60 patients (aged 41–86; 30% female) with nonvalvular, persistent atrial fibrillation from the group of 204 consecutive patients scheduled for DC during the 12-month period (from May 2010 to May 2011) in the Cardiology Clinic Medical University of Lodz, Poland. The study group was divided into SCD (successful DC), 45 (75%) patients, and NDC (nonsuccessful DC), 15 (25%) patients. Within the SCD group, the subgroups were distinguished depending on the time sinus rhythm maintenance after DC: up to 7 days (SDC-7), 11 patients; 7 to 30 days (SDC-30), 12 patients; over 90 days (SDC-90), 22 patients. Patients were evaluated during the hospitalization and within the 3-month follow-up period. The apelin level was determined within the plasma samples collected at the admission, using the commercially available enzyme-linked immunosorbent assay (ELISA) Kit for apelin-36. It was found that the median value of initial apelin in the subset of patients from groups NDC + SDC-7 + SDC-30 is significantly higher than from group SDC-90 (p=0.0463); there was no relationship between NDC and SCD overall. Neither of the compared subgroup pairs revealed statistically significant correlation between the proBNP concentration and the DC effectiveness in our population. In conclusion, in our study, proBNP was not a marker of arrhythmia recurrence whereas higher apelin concentration at the admission indicated patients in whom DC was not effective or they had an arrhythmia recurrence within a month-period observation.

Download Full-text

ABOUT THE ALLOCATION OF MENTAL DISORDERS RISK GROUPS IN THE PRACTICE OF CARDIOLOGY DEPARTMENT

Acta biomedica scientifica ◽

10.12737/article_5a3a0e794aff80.62275471 ◽

2018 ◽

Vol 2 (5) ◽

pp. 114-120 ◽

Cited By ~ 1

Author(s):

Мария Дорофейкова ◽

Mariia Dorofeikova ◽

Сергей Задворьев ◽

Sergey Zadvorev ◽

Наталия Петрова ◽

...

Keyword(s):

Mental Disorders ◽

Cardiac Arrhythmias ◽

Emotional State ◽

Heart Rhythm ◽

Female Gender ◽

Risk Groups ◽

Cardiology Department ◽

Heart Rhythm Disorders ◽

Paroxysmal Hypertension ◽

Emotional Condition

Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this study was to develop an algorithm for identification of the patients with indications for psychiatrist’s consultation and possible psychotropic therapy at the stage of admission to multi-disciplinary hospital. Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving psychotropic therapy at discharge. Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 × L + D + 3 × F + 3 (6) × H. Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic) profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.

Download Full-text

Peripheral blood leukocyte telomere length as a possible prognostic marker for the development of atrial fibrillation

Cardiosomatics ◽

10.26442/22217185.2020.2.200227 ◽

2020 ◽

Vol 11 (2) ◽

pp. 50-54

Author(s):

Svetlana Yu. Nikulina ◽

Ksenya Yu. Shihkova ◽

Vladimir A. Shulman ◽

Anna A. Chernova ◽

Vladimir N. Maksimov

Keyword(s):

Atrial Fibrillation ◽

Telomere Length ◽

Heart Rhythm ◽

Peripheral Blood Leukocyte ◽

Response To Therapy ◽

Leukocyte Telomere Length ◽

Risk Markers ◽

Heart Rhythm Disorders ◽

Blood Leukocyte

Atrial fibrillation is one of the most common heart rhythm disorders. The most prominent risk factor for atrial fibrillation is advanced age. Population ageing contributes to an increase in both the prevalence of this pathology and socio-economic burden of the disease for society in general and the patient in particular. Adequate therapy and prevention of atrial fibrillation requires the search for novel prognostic risk markers for disease development, progression, and patients response to therapy. One of these markers is the length of telomeres structures at the ends of chromosomes that protect them from degradation during cell division. The article provides an overview of world studies, both confirming and disproving the role of leukocyte telomere length in atrial fibrillation development.

Download Full-text

Direct oral anticoagulants in atrial fibrillation patients aged 75 years or older: Efficacy and safety balance

Terapevticheskii arkhiv ◽

10.17116/terarkh20178944-7 ◽

2017 ◽

Vol 89 (4) ◽

pp. 4-7 ◽

Cited By ~ 2

Author(s):

V V Fomin ◽

A A Svistunov ◽

D A Napalkov ◽

A A Sokolova ◽

M A Gabitova

Keyword(s):

Atrial Fibrillation ◽

Elderly Patients ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Research Programme ◽

Heart Rhythm ◽

Scientific Data ◽

Treatment And Prevention ◽

Heart Rhythm Disorders ◽

Prevention Of Thromboembolic Events

Atrial fibrillation (AF) is one of the most common heart rhythm disorders in the population. Researchers revealed a direct relationship between their incidence and a patient’s age long ago. One of the most challenging issues of clinical practice in patients with AF is anticoagulant therapy used in the so-called very elderly patients aged 75 years and older when age itself is a risk factor for developing both thromboembolic and hemorrhagic events due to anticoagulants, regardless of the mechanism of action of the latter. However, scientific data regarding the treatment and prevention of thromboembolic events in elderly and senile patients with AF are very scarce and often uninformative. The data from the EURObservational Research Programme-Atrial Fibrillation Registry Pilot Phase (EORP-AF Pilot) and the randomized clinical studies RELY, ROCKET AF, ARISTOTLE, and AVERROES were analyzed to identify the most safe and most effective anticoagulant for elderly patients (over 75 years). Relying on the analyses of literature data, the authors propose an algorithm based on clinical characteristics for choosing the anticoagulant for patients older than 75 years.

Download Full-text