Symptoms In Atrial Fibrillation: A Contemporary Review And Future Directions

Atrial fibrillation (AF) is the most prevalent arrhythmia leading to hospital admissions in the United States. The majority of patients with AF report symptoms associated with this condition that can lead to a decrease in health related quality of life (HRQOL) and functional status. Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. Our current understanding of how AF and symptoms are linked is hampered by the dominant assessment paradigm, where symptoms thought to be associated with AF are measured at a single point in time (frequently at a clinic visit). Unfortunately, this "static" snapshot does not capture the variability of symptoms and heart rhythm within a person over time and does not shed light on how symptoms are related to heart rhythm. This focused review summarizes current methods for assessing symptoms including generic and AF-specific HRQOL and functional status tools. It also describes gaps in the current assessment paradigm and where future research using mobile applications and digital technology might be able to assist with patient care.