Poster Exemplar
Title: Symptoms and Quality of Life in Elderly Patients with Arrhythmia
Background: Atrial and ventricular arrhythmias in the elderly with heart failure (HF) or hypertension
(HTN) have been well documented. However, in patients greater than 65 years, without a history of prior
atrial fibrillation (AF) the impact of these underlying disorders and the impact of perceived arrhythmia
symptoms and quality of life (QoL) has not been well defined.
Objective: The purpose of this study was to measure the frequency of symptoms and reported QoL in
individuals greater than 65 years with an underlying history of HTN and/or HF.
Method: Sixty three patients with a history of HF and/or HTN consented to wear the LifeStar AF
Express, an auto triggered cardiac loop monitor that captures EKG data, including silent and symptomatic
arrhythmias. Demographic and clinical data were collected; 72±6 yrs; 62% females; 72% Hispanic, 22%
black, 5% white/other, all had HF, and 95% had HTN. Baseline QoL was evaluated in 57 prior to wearing
the device with the SF-36v2 and the Atrial Fibrillation Severity Scale which reports severity of
subjectively perceived episodes of arrhythmias.
Results: All patients were in sinus rhythm. From the Life Star monitoring, 72% had ectopic activity and
30% were symptomatic including 9% with palpitations and 8% with dizziness. QoL did not correlate
significantly with recorded arrhythmias. Perceptions of diminished general health were significantly
correlated with symptoms of exercise intolerance (p=0.0005), lightheadedness/dizziness (p<0.0001),
palpitations (p=0.008), and chest pain/pressure (p=0.001), as well as severity of the last irregular heart
rhythm (p=0.01) In a multivariable logistic regression model, more severe arrhythmic episodes (p=.01)
and symptoms of exercise intolerance (p=.02), and dizziness (p=.0002) were independently associated of
a diminished QoL with odd ratios of 16.4, 7.7, and 23.6, respectively.
Discussion: Despite a lack of sustained arrhythmias, QoL was significantly worse at baseline prior to
monitoring in patients who perceived their arrhythmic episodes to be more severe as well as in individuals
whose symptoms included dizziness and exercise intolerance. These finding warrant further investigation,
in a larger more ethnically diverse population.
Author: Kathleen T. Hickey, EdD, ANP-BC, FNP-BC
Institution Affiliation: Columbia University School of Nursing
Position Title: Assistant Professor
SNRS membership: Not at time of Submission
Disclosures: none