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PubMed1998

Advanced life support vs basic life support field care: an outcome study.

OBJECTIVE: To determine whether the provision of advanced life support (ALS) field care has any impact on patient outcome in the urban Canadian environment. METHODS: A convenience cohort study was conducted of all emergent ambulance transfers of adults to an urban Canadian hospital from May 22 to July 31, 1996. Data were collected from ambulance call reports regarding presenting complaint and field interventions applied, and from hospital records regarding time in the ED, hospital length of stay (LOS), and discharge disposition. Patient outcomes were compared within 7 presenting complaint groups (chest pain, altered level of consciousness, shortness of breath, abdominal pain, motor vehicle crash, falls, and other) by field care level: level 1--BLS (basic life support) vs levels 2 and 3--ALS. RESULTS: The study population consisted of 1,397 patients. No significant differences were seen between BLS and ALS patients on baseline demographics. ED triage score did not depend on field care level for any group, implying that those in the ALS group were not inherently sicker. Outcome measures (ED LOS, admission rates, and hospital LOS) showed no significant differences between BLS and ALS for each presenting complaint group. Discharge dispositions were analyzed by chi2 but were not varied enough to allow reliable analysis. Observation of trends suggested no difference between BLS and ALS. CONCLUSIONS: There was no beneficial impact on the measured patient outcomes found in association with the provision of ALS vs BLS field care in Metropolitan Toronto for patients who were brought to a nontrauma center.

Adult↗
PubMed2003

Prospective assessment of Cleveland Global Quality of Life (CGQL) as a novel marker of quality of life and disease activity in Crohn's disease.

OBJECTIVES: The Short Form 36 (SF-36) questionnaire is the most widely accepted measure of quality of life (QOL); however, it is cumbersome to use and requires complicated analysis. The Cleveland Global Quality of Life (CGQL) is a simpler tool, which has been validated in patients with ulcerative colitis undergoing restorative proctocolectomy. This study validates CGQL in patients with Crohn's disease and determines the correlation of QOL measurement systems with disease activity as measured by the Crohn's Disease Activity Index (CDAI). METHODS: All patients with Crohn's disease presenting to this department between September 2001 and February 2002 were prospectively entered into a database, including demographic data, disease manifestations, Vienna classification, age at diagnosis, and duration of Crohn's disease. SF-36, CGQL, and CDAI scores were entered concurrently. Cronbach's alpha was used to assess the internal consistency among the components of the CGQL score. Correlation among various QOL measures was assessed with Spearman's test. Relationships between QOL measures and various baseline factors were assessed by Wilcoxon rank sum test, Student's t test, Kruskal-Wallis test, and Pearson's test, depending on the type and distribution of data. Change from baseline in the CGQL was assessed with the Wilcoxon signed rank test. RESULTS: One hundred seventy-eight (178) patients were entered into the database, and 169 completed QOL and CDAI data. There was a significant correlation between SF-36 and CGQL. CGQL and SF-36 correlated similarly with CDAI. Neither patient age, gender, or smoking history were associated with CGQL. CONCLUSIONS: CGQL correlates with disease activity and is a simple measure of QOL in Crohn's disease.

Adult↗
PubMed2004

Early life predictors of old-age life expectancy.

The laboratory of Richard Miller and numerous heroic collaborators are in the process of testing a variety of life span predictors on more than 1000 mice. In their most recent publication, Harper et al. show that early-adulthood measures of T cell subsets, body weight, and thyroxine can be effectively combined to provide a highly significant predictor of life expectancy. Each measure appears to be an index of largely separate parameters that affect the course of aging. This article summarizes the results, discusses implications, mentions caveats, and suggests future studies.

Aging↗
PubMed2005

The effect of ADHD on the life of an individual, their family, and community from preschool to adult life.

Attention deficit/hyperactivity disorder (ADHD) may affect all aspects of a child's life. Indeed, it impacts not only on the child, but also on parents and siblings, causing disturbances to family and marital functioning. The adverse effects of ADHD upon children and their families changes from the preschool years to primary school and adolescence, with varying aspects of the disorder being more prominent at different stages. ADHD may persist into adulthood causing disruptions to both professional and personal life. In addition, ADHD has been associated with increased healthcare costs for patients and their family members.

Adolescent↗
PubMed1998

Cardiovascular risk during early adult life. Risk markers among participants in "Live for Life" health promotion programme in Sweden.

STUDY OBJECTIVE: To study differences in cardiovascular lifestyle risk factors and biological risk markers in early adult life, with special attention to age and sex differences. Lifestyle cardiovascular risk factors included dietary habits, physical inactivity, smoking, alcohol habits, psychosocial strain, and mental stress. Biological risk markers included anthropometric variables, arterial blood pressure, and serum cholesterol concentration. DESIGN: A combined individual and community based preventive programme, including health examinations. SETTING: All communities in the County of Skaraborg in south western Sweden. PARTICIPANTS: Altogether 12,982 men and women aged 30 or 35 years who underwent health examinations over seven years. MAIN RESULTS: In both sexes, biological risk markers studied were worse in 35 year old subjects than in 30 year olds. Furthermore, a larger proportion of men aged 35 years were smokers and were physically inactive compared with 30 year old men. However, dietary habits were better in both sexes in the upper age group. At both ages there were also significant differences between men and women. Women, compared with men, had better dietary habits and lower alcohol consumption but smoked more and experienced greater mental stress and psychosocial strain. All biological risk markers were worse in men than in women at both ages studied. During the observation period, some improvement of the health profile of the participants was observed, indicating a beneficial effect of the intervention programme. CONCLUSIONS: The results indicate that the risk of cardiovascular disease, as assessed from studying lifestyle and biological risk markers, increases early in life, suggesting that preventive measures should start early.

Adult↗
PubMedDate not supplied

Evaluation of the quality of life in dementia with a generic quality of life questionnaire: the Duke Health Profile.

OBJECTIVE: The study was designed to determine the acceptability, feasibility and validity of measuring quality of life in a representative sample of dementia patients with a generic instrument, the Duke Health Profile. METHOD: The French version of the Duke Health Profile was administered to 148 subjects with a mental disorder according to the DSM-III-R diagnostic criteria. The feasibility and acceptability of employing the instrument were determined by the refusal rate, the type of administration, and the percentage and distribution of missing data. Reliability was determined with Cronbach's alpha coefficient. Instrument reproducibility was assessed with the intraclass correlation coefficient for test-retest values. Internal construct validity was determined by factor analysis. Discriminant capacity was determined by comparing the average scores on each measure among patients with and without an additional chronic pathology. The measurements obtained were compared by source of information (patient, family proxy and care provider proxy). RESULTS: The feasibility and acceptability of the instrument was good. Only 2% of the patients refused to complete the questionnaire. Help from the interviewer was necessary in 79% of the cases. The average completion time was 10.6 min. Missing data exist in only 3.5% of the cases on average, except among patients with severe dementia (Mini Mental State Examination <10). For reliability, internal consistency was acceptable (Cronbach's coefficient alpha = 0.5--0.7) when the self-esteem (0.23) and social health (0.26) concepts were eliminated. Reproducibility as measured by test-retest scores was moderate to good (intraclass correlation coefficient r = 0.53--0.80), except for anxiety (0.48) and perceived health (0.45). Severity of dementia mainly affected the feasibility, acceptability and reproducibility of the instrument. The family proxy seemed to agree more with the patient than did the care provider proxy. CONCLUSION: Quality of life can be measured in patients with dementia, but special tools need to be developed for severe dementia.

Aged↗
PubMed2002

Brief comprehensive quality of life assessment after stroke: the assessment of quality of life instrument in the north East melbourne stroke incidence study (NEMESIS).

BACKGROUND AND PURPOSE: Generic utility health-related quality of life instruments are useful in assessing stroke outcome because they facilitate a broader description of the disease and outcomes, allow comparisons between diseases, and can be used in cost-benefit analysis. The aim of this study was to validate the Assessment of Quality of Life (AQoL) instrument in a stroke population. METHODS: Ninety-three patients recruited from the community-based North East Melbourne Stroke Incidence Study between July 13, 1996, and April 30, 1997, were interviewed 3 months after stroke. Validity of the AQoL was assessed by examining associations between the AQoL and comparator instruments: the Medical Outcomes Short-Form Health Survey (SF-36); London Handicap Scale; Barthel Index; National Institutes of Health Stroke Scale; and Irritability, Depression, Anxiety scale. Sensitivity of the AQoL was assessed by comparing AQoL scores from groups of patients categorized by severity of impairment and disability and with total anterior circulation syndrome (TACS) versus non-TACS. Predictive validity was assessed by examining the association between 3-month AQoL scores and outcomes of death or institutionalization 12 months after stroke. RESULTS: Overall AQoL utility scores and individual dimension scores were most highly correlated with relevant scales on the comparator instruments. AQoL scores clearly differentiated between patients in categories of severity of impairment and disability and between patients with TACS and non-TACS. AQoL scores at 3 months after stroke predicted death and institutionalization at 12 months. CONCLUSIONS: The AQoL demonstrated strong psychometric properties and appears to be a valid and sensitive measure of health-related QoL after stroke.

Adult↗
PubMed2001

Disease specific quality of life instruments in multiple sclerosis: validation of the Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS).

Quality of life (QoL) is discussed as an additional outcome measure in multiple sclerosis (MS). However, few questionnaires assessing disease specific QoL in MS have been published. On the basis of the literature and interviews with clinicians and MS patients, we have developed a disease specific QoL instrument and validated it in a broad range of patients with MS. In this study, a heterogeneous sample of n = 237 MS patients completed the newly developed Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS, in German language) and a battery of already validated questionnaires. They further underwent neurological scoring and objective tests. By these means, we investigated its validity, appropriateness, internal consistency, and retest reliability. Internal consistency and retest coefficients were high and satisfied psychometric standards. Convergent and discriminant validity was supported by direction, magnitude and pattern of correlations with other health measures. HAQUAMS subscales and its total score distinguished between patient groups of varied disease severity, cognitive impairment, and affective symptomatology. No floor or ceiling effects were found in either of the HAQUAMS subscales. The HAQUAMS is a reliable, valid and appropriate instrument for QoL assessment in multiple sclerosis. Data of responsiveness are currently being obtained.

Adult↗
PubMed2004

An instrument for measuring health-related quality of life in patients with Deep Venous Thrombosis (DVT): development and validation of Deep Venous Thrombosis Quality of Life (DVTQOL) questionnaire.

BACKGROUND: Few studies have evaluated patient-reported outcomes in connection with a primary event of deep venous thrombosis, partly due to a lack of disease-specific measures. The aim here was to develop a disease-specific health-related quality of life (HRQL) measure, the deep venous thrombosis quality of life questionnaire (DVTQOL), for patients with recent exposition and treatment of proximal deep venous thrombosis. METHODS: A total of 121 consecutive outpatients (50 % males; mean age 61.2 +/- 14 years) treated with warfarin (Waran) for symptomatic proximal deep venous thrombosis were included in the study. Patients completed the SF-36, EQ-5D and the pilot version of the DVTQOL. RESULTS: Items having: high ceiling and floor effect, items with lower factor loadings than 0.50 and items loading in several factors were removed from the pilot version of DVTQOL. In addition, overlapping and redundant items identified by the Rasch analysis were excluded. The final DVTQOL questionnaire consists of 29 items composing six dimensions depicting problems with: emotional distress; symptoms (e.g. pain, swollen ankles, cramp, bruising); limitation in physical activity; hassle with coagulation monitoring; sleep disturbance; and dietary problems. The internal consistency reliability was high (alpha value ranged from 0.79 to 0.93). The relevant domains of the SF-36 and EQ-5D significantly correlated with DVTQOL, thereby confirming its construct validity. CONCLUSIONS: The DVTQOL is a short and user-friendly instrument with good reliability and validity. Its test-retest reliability and responsiveness to change in clinical trials, however, must be explored.

Adult↗
PubMed2005

Adolescent distinctions between quality of life and self-rated health in quality of life research.

BACKGROUND: In adult quality of life (QOL) research, the QOL construct appears to differ from self-rated health status. Although increased QOL continues to be recognized as an important outcome in health promotion and medical intervention, little research has attempted to explore adolescent perceptual differences between self-rated health and QOL. METHODS: Correlational analyses were performed between self-rated health, physical health days and mental health days, and QOL. Data were collected from two different public high school adolescent samples during two different time periods (1997 & 2003) in two different geographic regions in the USA (a southern & midwestern state) with two different sample sizes (N = 5,220 and N = 140, respectively) using the CDC Youth Risk Behavior Survey (YRBS). The Centers for Disease Control and Preventions' health-related quality of life scale (HRQOL) provided estimates of self-rated health, physical health days and mental health days, and QOL. RESULTS: All correlation coefficients were significant in both samples (p < or = .0001), suggesting sample size was not a contributing factor to the significant correlations. In both samples, adolescent QOL ratings were more strongly correlated with the mean number of poor mental health days (r = .88, southern sample; r = .89, midwestern sample) than with the mean number of poor physical health days (r = .75, southern sample; r = .79, midwestern sample), consistent with adult QOL research. However, correlation coefficients in both samples between self-rated health and the mean number of poor physical health days was slightly smaller (r = .24, southern, r = .32, midwestern) than that between self-rated health and the mean number of poor mental health days (r = .25, southern, r = .39 midwestern), which is contrary to adult QOL research. CONCLUSION: Similar to adults, these results suggest adolescents are rating two distinct constructs, and that self-rated health and QOL should not be used interchangeably. QOL, in the context of public high school adolescents, is based largely upon self-reported mental health and to a lesser extent on self-reported physical health. Conversely, although self-reported mental health and self-reported physical health both contribute significantly to adolescent self-rated health, mental health appears to make a greater contribution, which is contrary to observations with adults. Health promoting efforts for adolescents may need to focus more on mental health than physical health, when considering population needs and type of micro or macro intervention.

Adolescent↗
PubMed2003

Use of complementary and alternative medicine and quality of life: changes at the end of life.

The purpose of this study was to compare the physical, psychological and social dimensions associated with quality-of-life outcomes over the last year of life, between advanced cancer users and nonusers of complementary and alternative medicine. One hundred and eleven patients were identified through Queensland Cancer Registry records, and followed up every four to six weeks until close to death using standardized protocols. Outcome measures were symptom burden, psychological distress, subjective wellbeing, satisfaction with conventional medicine and need for control over treatment decisions. At the initial interview, 36 (32%) participants had used complementary/alternative medicine the previous week; mainly vitamins, minerals and tonics and herbal remedies. Among all participants, 53 (48%) used at least one form of complementary/alternative medicine over the study period. Only six (11%) visited alternative practitioners on a regular basis. Overall, complementary/alternative medicine users reported higher levels of anxiety and pain, less satisfaction with conventional medicine and lower need for control over treatment decisions compared with nonusers. These differences tend to change as death approaches. A more rigorous assessment of complementary/alternative medicine use, psychological distress, pain and subjective wellbeing among patients with advanced cancer is needed in the clinical setting.

Aged↗
PubMed1989

Life events, life difficulties and confiding relationships in the depressed elderly.

A total of 101 elderly depressed patients and 85 community residents (matched for age and sex) were interviewed about life events, difficulties, and confiding relationships. Significantly more of the depressed sample reported at least one severe event in the three months before the onset of their illness. Lack of a good confiding relationship was associated with depression in men but not in women. In this relatively affluent Australian sample, life difficulties were rare and, probably as a result, were not significantly associated with depression.

Aged↗
PubMed2000

Quality of life in schizophrenia: development, reliability and internal consistency of the Lancashire Quality of Life Profile--European Version. EPSILON Study 8. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs.

BACKGROUND: This paper, part of the European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study, reports the development, reliability and internal consistency of the Lancashire Quality of Life Profile--European Version (LQoLP-EU) in a representative sample of people with schizophrenia from five European sites. METHOD: The LQoLP-EU was administered to a total sample of 404 patients to check its internal consistency, and a sub-sample of 294 patients was interviewed a second time within 7-15 days to verify its test-retest reliability. RESULTS: Internal consistency of the total domains, perceived QoL scale (Life Satisfaction Scale, LSS) was good at 0.87. Of the nine subjective QoL domains Work and Leisure showed the lowest internal consistency (0.30 and 0.56 respectively), the values of the remaining sub-scales ranging between 0.62 and 0.88. The pooled ICC score for LSS was 0.82, and for the nine subjective QoL domain sub-scales it ranged from 0.61 (Safety) to 0.75 (Living Situation). There were significant differences between the sites in alpha and ICCs for sub-scales, but not for the LSS. CONCLUSION: The LQoLP-EU has good internal consistency and reliability in the five European centres.

Adolescent↗
PubMed1999

Comparison of two quality-of-life instruments for cancer patients: the functional assessment of cancer therapy-general and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30.

PURPOSE: To compare two quality-of-life (QOL) questionnaires for cancer patients, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy-General (Fact-G), on the basis of empirical data. PATIENTS AND METHODS: Two hundred forty-four patients with a diagnosis of breast cancer or Hodgkin's disease completed both the EORTC QLQ-C30 and the FACT-G (German language version) during the same session. Questionnaire data were analyzed on a subscale basis using correlation analysis, canonical correlation, and multiple linear regression. RESULTS: Correlations between corresponding subscales of the FACT-G and the EORTC QLQ-C30 ranged from r =.14 for the social domain (very poor agreement) to r =.66 for the physical domain (good agreement), with r values for the other domains lying between these extremes. Canonical correlation analysis for the two sets of subscales revealed that overall agreement between the two instruments was only moderate (first canonical correlation coefficient r =.85, but overall redundancy less than 40%). Of the five FACT-G subscales, only one, physical well-being, was well represented by the EORTC QLQ-C30 subscales (multiple linear regression, R(2) =.67). Only three of eight EORTC QLQ-C30 subscales (physical functioning, global QOL, general symptoms) were represented fairly well by FACT-G subscales (R(2) =.43 to.60). The lowest R(2) values (<.15; ie, virtually no representation by the other instrument) were found for the FACT-G social well-being and relation with doctors and EORTC QLQ-C30 cognitive functioning subscales. CONCLUSION: For the sample investigated, the EORTC QLQ-C30 and the FACT-G were found to measure markedly different aspects of QOL, despite considerable overlap. Replicability provided, this implies that neither of the two QOL instruments can be replaced by the other and that a direct comparison of results obtained with the two instruments is not possible.

Adult↗
PubMed2004

Assessing quality of life during chemotherapy for pleural mesothelioma: feasibility, validity, and results of using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire and Lung Cancer Module.

PURPOSE: To assess the feasibility and validity of using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Lung Cancer Module (QLQ-LC13) to describe health-related quality of life (HRQL) in patients with pleural mesothelioma undergoing combination chemotherapy, to identify the most impaired aspects of HRQL, and to assess the impact of chemotherapy on HRQL. PATIENTS AND METHODS: Fifty-three patients received cisplatin on day 1 and gemcitabine on days 1, 8, and 15 of a 28-day cycle for a maximum of six cycles. HRQL was assessed using the EORTC QLQ-C30 and QLQ-LC13. RESULTS: Compliance was 100% at baseline but subsequently decreased. At baseline, role function and social function were the most impaired domains, and the worst-rated symptoms were fatigue, dyspnea, pain, insomnia, appetite loss, and cough. Dyspnea, pain, insomnia, and cough improved with chemotherapy, although functional domains and chemotherapy-related symptoms deteriorated. Fatigue remained unchanged. Few patients reported hemoptysis. Functional domains and symptoms scales from the QLQ-C30 demonstrated predictive validity for survival. The predictive value of QLQ-LC13 pain scores was improved by combining three pain items into a single score. Dyspnea scores were correlated strongly with lung function as measured by forced vital capacity. CONCLUSION: This study supports the validity of the EORTC QLQ-C30 and LC13 as outcome measures for trials of chemotherapy in mesothelioma. Although the most prominent symptoms reported were concordant with clinical experience, impairments in role and social function and insomnia were worse than expected. Future research should focus on how best to apply, analyze, and interpret existing, validated HRQL instruments in mesothelioma research and practice, not on the development of new ones.

Aged↗
PubMed2004

Long-term improvement of quality of life during growth hormone (GH) replacement therapy in adults with GH deficiency, as measured by questions on life satisfaction-hypopituitarism (QLS-H).

Questions on Life Satisfaction-Hypopituitarism (QLS-H) is a new quality-of-life (QoL) questionnaire developed for adults with hypopituitarism. To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Z-scores in 576 adult patients with GH deficiency (GHD) enrolled in HypoCCS, an international observational study, using data from five countries in which comparative QLS-H data from the general population were available. Baseline QLS-H Z-scores were significantly lower in GH-deficient patients than in the general population of the same age, gender, and nationality. Z-scores were also significantly lower in female patients vs. males (P = 0.006) and in adult-onset vs. childhood-onset GHD (P = 0.002). Multivariate analysis associated female gender, multiple pituitary hormone deficiencies, low serum IGF-I values (<75 micro g/liter), and concomitant antidepressant medication with low baseline Z-scores. QLS-H Z-scores increased from -1.02 +/- 1.43 (SD) at baseline to -0.25 +/- 1.34 (SD) after 1 yr of GH treatment (P < 0.001) and were no longer significantly different from the general population after 4 yr of treatment. There was no correlation between change in Z-score and GH dose or changes in IGF-I and IGF binding protein-3 during treatment. This study demonstrates that 1) improvements in QoL, as measured by the QLS-H, are maintained during long-term GH replacement therapy of adults with GHD, and 2) the QLS-H is a useful tool for evaluating QoL in hypopituitary patients treated in clinical practice. The authors suggest that evaluation of QoL should be a part of the routine clinical management of adult GH-deficient patients, complementing the measurement of surrogate biological markers or other clinical end points.

Adult↗
PubMed2005

Quality of life (QOL) in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire.

Acromegaly Quality of Life Questionnaire (AcroQoL) is a new disease-generated quality of life (QOL) questionnaire comprising 22 questions covering physical and psychological aspects of acromegaly and subdivided into "appearance" and "personal relations" categories. We have performed a cross-sectional study of QOL in 80 patients [43 male (mean age, 54.2 yr; range, 20-84); median GH, 0.93ng/ml (range, <0.3 to 23.7); IGF-I, 333.1 ng/ml (range, 47.7-899)] with acromegaly. In addition to AcroQoL, patients completed three generic QOL questionnaires: Psychological General Well-Being Schedule (PGWBS), EuroQol, and a signs and symptoms score (SSS). All three generic questionnaires confirmed impairment in QOL [mean scores: PGWBS, 69.6; EuroQol, visual analog scale, 66.4 (range, 20-100) and utility index, 0.7 (range, -0.07 to 0.92); and SSS, 12 (range, 0-27)]. There was no correlation between biochemical control and any measure of QOL. AcroQoL (57.3%; range, 18.2-93.2) correlated with PGWBS (r = 0.73; P < 0.0001); and in patients with active disease, AcroQoL-physical dimension correlated with SSS (r = -0.67; P < 0.0003). In all questionnaires, prior radiotherapy was associated with impaired QOL. In conclusion, these data underline the marked impact that acromegaly has on patients' QOL and provide the first evidence validating AcroQoL against well-authenticated measures of QOL. This indicates the potential of AcroQoL as a patient-friendly measure of disease activity.

Acromegaly↗
PubMed2006

Rate control and quality of life in patients with permanent atrial fibrillation: the Quality of Life and Atrial Fibrillation (QOLAF) Study.

BACKGROUND: The present study aimed to determine whether quality of life (QOL) in permanent atrial fibrillation (AF) patients would be improved by monotherapy with beta-blocker (BB) or calcium antagonist (CAA) as compared with digitalis. METHODS AND RESULTS: Twenty-nine patients with permanent AF under digitalis were randomized into BB (bisoprolol, atenolol or metoprolol) or CAA (verapamil) monotherapy treatment group. Twenty-five were men and the mean age was 67+/-8 years. After the assigned monotherapy, 12 patients received the other monotherapy in a cross-over fashion. Under each treatment, efficacy of rate control was determined by Holter electrocardiogram (ECG), treadmill testing and QOL questionnaire (Short Form-36 (SF-36) and Quality of Life of Atrial Fibrillation (AFQLQ)), and compared with the baseline digitalis treatment. CAA significantly increased mean and minimum heart rate (HR) in Holter ECG as compared with digitalis, whereas BB increased only minimum HR. Exercise duration in treadmill testing was significantly prolonged by CAA treatment, although it only tended to be prolonged by BB treatment. CAA but not BB improved role function-physical score of SF-36, and frequency and severity of symptoms of AFQLQ. CONCLUSION: These results indicate that CAA is preferable to digitalis when monotherapy is selected for short-term improvement of QOL and exercise tolerance in patients with permanent AF.

Adrenergic beta-Antagonists↗