Cardiorespiratory fitness and electroanatomical remodelling in patients with atrial fibrillation

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

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

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab060 ◽

2021 ◽

Vol 20 (Supplement_1) ◽

Author(s):

N Swiatoniowska-Lonc ◽

D Kasperczak ◽

B Jankowska-Polanska

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Important Determinant ◽

Heart Rhythm ◽

Positive Influence ◽

Physically Active ◽

Funding Sources ◽

Cardiology Department ◽

Heart Rhythm Disorders ◽

Acceptance Of Illness

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.

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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.

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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.

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Abstract 20107: Randomized Comparison of Personalized versus Standardized Substrate Modification During Catheter Ablation for Symptomatic Atrial Fibrillation

Circulation ◽

10.1161/circ.132.suppl_3.20107 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Simon Kircher ◽

Arash Arya ◽

David Altmann ◽

Sascha Rolf ◽

Andreas Bollmann ◽

...

Keyword(s):

Atrial Fibrillation ◽

Low Voltage ◽

Randomized Study ◽

Standard Group ◽

Linear Lesions ◽

Substrate Modification ◽

Arrhythmogenic Substrate ◽

Group 2 ◽

Group 1

Introduction: Pulmonary vein (PV) isolation forms the cornerstone of any ablation procedure for atrial fibrillation (AF). There is, however, no uniform strategy how to detect and target left atrial (LA) arrhythmogenic substrate outside the PV antra. Fibrosis that corresponds well to LA low-voltage areas (LVAs) seems to play a key role in AF arrhythmogenesis and might therefore be a suitable target for additional substrate modification (SM). Objective: The purpose of this prospective randomized study was to compare a novel technique for SM based on ablation of potentially arrhythmogenic LA LVAs with a standard approach consisting of empiric LA linear ablation. Methods: Patients (pts) with symptomatic paroxysmal or persistent AF were randomized to standard (group 1) or personalized (group 2) SM. Circumferential PV isolation was the primary step in both groups. In group 1, pre-defined linear lesions were applied at the LA roof and bottom, respectively, and at the mitral isthmus only in pts with persistent AF. In group 2, targets for SM (i.e. LVAs) were identified by detailed bipolar voltage mapping (BVM) during sinus rhythm irrespective of AF type. Peak-to-peak electrogram amplitudes were defined as “normal” (> 0.5 mV), as “low voltages” (0.2 to 0.5 mV), or as “scar” (< 0.2 mV). LVAs were targeted by tissue homogenization and / or strategic linear lesions. The primary endpoint was freedom from any atrial arrhythmia (i.e. AF, atrial flutter, or atrial tachycardia) > 30 seconds off antiarrhythmic drugs on serial 7-d-Holter ECG recordings after a follow-up period of 12 months. Results: In total, 124 ablation-naïve pts (mean age 63 ± 9 years, 62 % male, 49 % with persistent AF) were enrolled in this study. LVAs were present in 18 % of pts with paroxysmal and in 41 % of pts with persistent AF (p<0.05). At the end of the follow-up period, 25 out of 59 pts (42 %) in the conventional group were free from arrhythmia recurrence as compared to 40 out of 59 pts (68 %) in the BVM-guided group (unadjusted log rank p = 0.003). Conclusion: Personalized SM guided by endocardial BVM is associated with a higher success rate compared to a conventional approach applying empirical SM based on AF phenotype.

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Abstract 13692: Cardiorespiratory Fitness and Atrial Fibrillation Risk in African American Veterans

Circulation ◽

10.1161/circ.142.suppl_3.13692 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Apostolos Tsimploulis ◽

charles faselis ◽

Eric J Rashba ◽

Hans Moore ◽

Pamela Karasik ◽

...

Keyword(s):

Atrial Fibrillation ◽

African American ◽

Cardiorespiratory Fitness ◽

Washington Dc ◽

Beneficial Effects ◽

Metabolic Equivalents ◽

Exercise Treadmill ◽

The Usa ◽

Cox Proportional Hazard Models ◽

Cv Disease

Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia, affecting >10 million in the USA. The beneficial effects of cardiorespiratory fitness (CRF) on cardiovascular (CV) diseases are well-documented. Interestingly, African American (AA) individuals are less prone to develop AF. Little is known about the association between CRF and AF in AA men. Hypothesis: CRF-AF risk association in AA men. Methods: We identified 11,216 AA Veterans with a mean age (±SD) 58±11 years who completed a symptom-limited exercise treadmill test at the VAMCs in Washington DC and Palo Alto CA. None exhibited evidence of ischemia or AF during and prior to it. We established four fitness groups based on age-specific quartiles of peak metabolic equivalents (METs) achieved: Least-Fit: 4.4 ±1.2 METs (n=2,530); Moderate-Fit: 6.6±1.3 METs (n=3,361); Fit: 8.1±1.4 METs (n=2,719) and High-Fit: 11.2±2.4 METs (n=2,606). AF was identified by a search of the medical records CPRS (database) using ICD coding and verified by 2 investigators. Cox proportional hazard models adjusted for age, CV disease, CV medications and risk factors were constructed to assess the CRF-AF association. P-values <0.05 using two sided tests were considered statistically significant. Results: During a mean follow-up period of 10.7±6.2 years, 1,423 patients developed AF; 421(16.6%) in the Least-Fit, 366 (10.9%) in Moderate-Fit, 323 (11.9%) in Fit and 313 (12%) in the High-Fit group. The CRF-AF association was inverse and graded. When compared to the patients in the Least-Fit group, the AF risk in the Moderate-Fit group was 29% lower (HR=0.71; 95% CI: 0.62-0.82, p<0.001). For Fit and High-Fit patients, the risk was 37% (HR=0.63; 95% CI: 0.54-0.73, p<0.001) and 51.0% lower (HR=0.49; 95% CI: 0.42-0.57, p<0.001), respectively. Conclusion: In this cohort, higher fitness levels reduced and delayed the risk of atrial fibrillation. The CRF-AF association was inverse, graded and independent of comorbidities.

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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.

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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.

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Safety and acute clinical outcomes of atrial fibrillation catheter ablation in octogenarians: a multicentre evaluation with a matched younger cohort

EP Europace ◽

10.1093/europace/euab116.235 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

N Karim ◽

N Kozhuharov ◽

J Jarman ◽

S Furniss ◽

R Veasey ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

De Novo ◽

Lv Function ◽

P Value ◽

Complication Rates ◽

Success Rates ◽

Af Ablation ◽

Funding Sources ◽

Procedural Success

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Sven Knecht and the International Octogenarian AF ablation group Background Octogenarians are a fast-growing demographic with a high burden of atrial fibrillation (AF). There are limited data on procedural safety and acute outcomes of catheter ablation (CA) for AF in this group. Purpose Investigation of complications & outcomes in octogenarians undergoing CA for AF. Methods Data on all octogenarian patients who underwent AF ablation at nine European cardiology centres between 2013 and 2019 were retrospectively analysed and matched with control patients aged <80 years. The characteristics used for matching were type of AF, type of procedure (de novo or redo), & the year of procedure. Results 216 octogenarians (81.9 ± 1.9 years; 52.8% females) underwent an AF ablation procedure, and were matched with 216 patients aged <80 years (62.4 ± 9.5 years, 34.7% females), p <0.001 for both. The proportion of paroxysmal and persistent AF was 43.5% & 56.5% respectively in both groups, and 79.3% of the procedures were de novo. RF ablation made up 75.4% & 75.9% (p = 0.90) procedures in octogenarians and controls respectively. 17 complications occurred in 14 (7.9%) octogenarian patients and 11 in 11 (5.1%) patients in the younger matched cohort (p = 0.07). There were 4.2% & 1.9% major complications (p= 0.17) and 3.7% & 3.2% minor complications (p= 0.77) in the octogenarian & younger cohorts respectively. Complications in octogenarians consisted of groin complications (n = 6), pneumonia (n = 3), pericardial effusion (n = 2), phrenic nerve injury (n = 2), pulmonary oedema (n = 1), gastroparesis (n = 1), stroke (n = 1). Acute procedural success rates were 99.1% & 99.5% (p = 0.62) The complication rates were similar for RF; 6.0% vs 5.4% (p = 0.79) and Cryoballoon; 14.0% vs 4.1% (p = 0.09) in both octogenarians and younger cohort respectively. Conclusion In spite of significantly higher overall risk profile of octogenarians undergoing AF ablation, there is no difference in acute procedural success and complication rates as compared to younger patients Catheter ablation of AF in octogenerians Octogenarians n = 216 Matched Controls (aged < 80yrs) n = 216 P value Age (yrs), mean (SD)s 81.9 (1.9) 62.4(9.5) < 0.0001 Females, (%) 52.8 34.7 0.0002 CHA2DS2-VASc, mean (SD) 3.6 (1.2) 1.4 (1.3) < 0.0001 Mean LA size, mm 42.8 ± 8.3mm 45.8 ± 16.2 0.062 Impaired LV function, (%) 23.7 17.9 0.206 IHD, (%) 20.7 5.9 < 0.0001 Procedural time (mins), mean (sd) 150.6 (69.7) 148.9 (64.4) 0.914 All complications, n (%) 17 (7.9) 11 (5.1) 0.073

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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.

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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.

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