Health-related quality of life in Brazilian pacemaker patients

Most quality of life (QoL) studies of pacemaker patients have been conducted in either North America or Europe and their applicability to Latin American populations is largely unknown. Our aim is to study health-related QoL indices in Brazilian pacemaker patients and their determinants using both a generic (SF-36) and a disease-specific questionnaire (AQUAREL).

The study enrolled 139 clinically stable patients (aged 59 +/- 14, 60.4% female) without any communication or cognitive impairments who went to the Pacemaker Laboratory for postimplantation follow-up. All patients were submitted to a standard protocol, which included an interview, functional class assessment, and QoL questionnaires. Additionally, 74 patients were requested to perform a 6-minute walk test.

Female patients and patients without a partner displayed low QoL scores in both the SF-36 mental component summary and the AQUAREL arrhythmia domain. Chagas disease patients displayed low scores only in AQUAREL domains. All health-related QoL scores were low in patients with the worst, high-numbered functional classes, the strongest determinant of low QoL scores in multivariate analysis.

In this first systematic study of QoL in a Latin American pacemaker population, AQUAREL detected well-impaired health-related QoL scores in different groups of patients, particularly in those with Chagas disease. Heart failure, evaluated by functional class, was the strongest predictor of low QoL in pacemaker patients.