Moqeem Komal, Beeharry Mohammad Waseem, Fang Tiffany, Lim Khei Jazzle M, Tsouklidis Nicholas
Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Medicine, Royal Surrey County Hospital, Guidford, GBR.
Cureus. 2020 Dec 28;12(12):e12341. doi: 10.7759/cureus.12341.
Atrial fibrillation (AF) is a growing public health concern, the impact of which is frequently underestimated. It has a profound effect on the quality of life (QoL) which appears to be disproportionately lower in female patients compared to men. We aim to explore the factors contributing to sex-related disparities in the QoL of AF patients by conducting a systematic review using the PubMed electronic search database. We used the following combination of medical subject heading (MeSH) parameters: "atrial fibrillation" and "sex" and "quality of life" with specific inclusion and exclusion criteria. We identified 13 relevant studies published between 2010 and 2020 for our review. These studies evaluated sex-related differences in QoL scores, symptom burden, and AF-related complications originating across different continents in Asia, Europe, and North America. We found that female patients reported a reduced QoL as compared to men and they were more likely to be older with multiple co-morbidities at presentation. Women also reported more frequent and severe symptoms, potentially explained by the greater prevalence of anxiety and depression and thus enhancing symptom perception. Moreover, they were less likely to be managed by anti-arrhythmic medications and invasive rhythm control strategies such as catheter ablation. Female patients with AF experienced more severe strokes, but no sex disparities were found in AF-related cognitive decline. We determined that the more prominent contributory factors towards a lowered QoL in female AF patients appear to be secondary to a higher burden and perception of symptoms as well as under-utilization of invasive treatment modalities. However, further studies are warranted to confirm these findings.
心房颤动（AF）是一个日益引起公众健康关注的问题，其影响常常被低估。它对生活质量（QoL）有深远影响，女性患者的生活质量似乎比男性患者低得不成比例。我们旨在通过使用PubMed电子搜索数据库进行系统综述，探索导致房颤患者生活质量性别差异的因素。我们使用了以下医学主题词（MeSH）参数组合：“心房颤动”、“性别”和“生活质量”，并制定了具体的纳入和排除标准。我们确定了2010年至2020年间发表的13项相关研究进行综述。这些研究评估了亚洲、欧洲和北美洲不同大陆的生活质量评分、症状负担和房颤相关并发症的性别差异。我们发现，与男性相比，女性患者报告的生活质量较低，她们在就诊时更可能年龄较大且患有多种合并症。女性还报告了更频繁、更严重的症状，这可能是由于焦虑和抑郁的患病率更高，从而增强了症状感知。此外，她们接受抗心律失常药物和导管消融等侵入性节律控制策略治疗的可能性较小。房颤女性患者发生更严重的中风，但在房颤相关的认知衰退方面未发现性别差异。我们确定，导致房颤女性患者生活质量降低的更突出的促成因素似乎是由于更高的症状负担和感知以及侵入性治疗方式的利用不足。然而，需要进一步的研究来证实这些发现。
