Doctors May Miss a Beat with A-Fib Patients

Atrial fibrillation patient assessment of mental and physical health may differ from doctor

(RxWiki News) Heart rhythm doctors who treat atrial fibrillation may not always be on the same page as patients when it comes to evaluating patient depression and other quality of life factors.

Atrial fibrillation (AFib) is one of the most common heart arrhythmias.

Along with the irregular heartbeat, AFib patients can experience quality of life issues—mental health problems, sleeping disorders and low levels of physical activity.

In looking at patients who have paroxysmal Afib (which occurs occasionally), scientists have recently found that heart rhythm doctors may be giving a rosier assessment of these quality of life factors than the patient is actually experiencing.

"Ask your doctor about depression screening."

Karl-Heinz Ladwig, MD, professor of psychosomatic medicine and psychological medicine at the Medical Faculty of the Technical University of Munich (TUM) and head of the Mental Health Epidemiology Unit at the Helmholtz Center, served as the lead author on this study.

Dr. Ladwig and his colleagues set out to evaluate the level of agreement between paroxysmal Afib patients and their electrophysiologists (heart rhythm doctors) regarding the assessment of the patient’s health status.

The researchers analyzed data on 334 patients with paroxysmal Afib but without significant cardiac disease. Patients and their doctors completed a questionnaire rating the patient’s quality of life. Physicians had no access to the patient's answer sheets.

Results show physicians rated their patients' health-related quality of life higher than the patients did—both for the mental component score and physical component score. The greatest level of disagreement was about mental health. Electrophysiologists also scored patients higher when it came to sleep disorders and physical activities.

"When one considers the importance placed on quality of life in the AF literature, these levels of discordance between physicians and patients are surprisingly large,” said Dr. Ladwig in a statement. “They underline the need for physicians to be trained to recognize depression in patients and for the introduction of systematic screening for depression in all AF clinics."

Dr. Ladwig added, “If EPs [electrophysiologists] don't know that their patients are suffering from depression they may not be offering them optimum treatments. Good communication between physicians and patients is of paramount importance for adherence to medications and long term prognosis."

Future studies should explore whether interventions such as physician training and screening, improve both quality of life and the underlying disease status of patients with AF, according to Dr. Ladwig.

The abstract study was presented at the EHRA EUROPACE meeting June 23 to 26 in Athens, Greece.

Review Date: 
June 23, 2013