Educational attainment is associated with atrial fibrillation symptom severity

Background: Atrial fibrillation (AF), the most common arrhythmia encountered in clinical practice, is often managed with a rhythm control strategy. Despite the emphasis on symptom relief as the motivation for a rhythm controlling strategy in AF, it remains unclear what factors affect the patient's experienced severity of AF symptoms. We hypothesize that demographic variables may affect AF symptom severity as many AF symptoms (palpitations, dyspnea, fatigue) are nonspecific and may require particular patient insight. Methods: We assessed demographic variables, cardiac and noncardiac comorbidities, AF burden, and AF-specific self-reported symptom severity in a cohort of 300 outpatients with AF presenting to outpatient electrophysiology clinics. Results: In unadjusted analyses, decreased educational attainment, unemployed working status, and non-Caucasian race were associated with worsened AF symptom severity. After adjusting for potential confounders, the association of decreased educational attainment with worsened AF symptom severity persisted. Conclusions: Possible links between these demographic features and AF symptom severity are socioeconomic status and health literacy. Further study into the relationship between educational attainment and AF symptom severity is warranted. (PACE 2012; 35:1090-1096)