Living with AF – Spouses and significant others suffer too!

BOSTON, MASSACHUSETTS. While lone atrial fibrillation (LAF) is not life-threatening, it certainly can, as most afibbers will readily attest to, play serious havoc with ones quality of life. Most afibbers are well aware that their spouses or partners are also affected, but up until now, the magnitude of the partner’s decline in quality of life (QoL) has not been quantified. This gap in our knowledge has now been closed by a group of researchers at the Brigham and Women’s Hospital.

The QoL study involved 411 afibbers (54% male) and 129 partners (33% male) who completed questionnaires during an educational symposium “Living with Atrial Fibrillation”. The average age of the afibbers was 67.6 years (90% were over the age of 55 years) and that of their partners was 65 years (82% were over the age of 55 years). The majority of the afibbers (61%) had been diagnosed more than 5 years ago and, as expected, most (54%) had the paroxysmal variety of AF, while 23% had persistent, and the remaining 23% permanent.

The overall effect on QoL was deemed to be mild by 42% of afibbers and 44% of partners. Another 26% of AF patients and 25% of partners thought the effect was moderate, while the remaining 32% of afibbers and 31% of partners thought their QoL had been severely affected. It is clear from these findings that the partners of afibbers experience a QoL deterioration similar to that of the afibbers themselves.

The decline in QoL was perceived as considerably more severe in afibbers and partners below the age of 55 years. In this age group, 41% of afibbers and 35% of partners rated the effect as severe with only 17% and 22% respectively rating it as mild. The effect on QoL clearly diminished with age with 50% of study participants 70 years or older reporting mild effect and 30% reporting severe effect. The deterioration of QoL was more pronounced in female afibbers (severe effect in 36%) than in male afibbers (severe effect in 28%).

A subgroup analysis produced data regarding the specific effect of AF in regard to daily activity, work life, sex life, physical activity, psychological well-being, and social activity. The percentage of afibbers and partners who reported a moderate or severe negative effect on their QoL is presented in the table below. NOTE: The percentage of afibbers who reported no or only mild QoL effect is 100 minus the percentage for moderate or severe effect.

Daily activity
Work life
Sex life
Physical activity
Psychological well-being
Social activity

The reason for the relatively low effect on work life is possibly related to the fact that the average age of the participants was 68 years making it likely that many were retired and therefore had no work commitment.

The above data clearly shows that AF, although being a relatively benign chronic disease, can be very limiting for the patient and therefore also limiting for a person who shares the life and activities of the patient. The authors of the study conclude that, “Our findings emphasize that health care providers should not only focus on the patient with AF but should take the spouse into account as well when managing this condition.”

Bohnen, M, Koplan, BA, et al. Quality of life with atrial fibrillation: Do the spouses suffer as much as the patients? PACE, April 28, 2011 [Epub ahead of print]