Atrial Fibrillation Through the Patient’s Eyes

Atrial Fibrillation Through the Patient’s Eyes

Edward P. Havranek, MDFrom the Denver Health Medical Center, University of Colorado Denver School of Medicine, Denver, Colo.
Correspondence to Edward P. Havranek, MD, 777 Bannock St, No. 0960, Denver, CO 80204-4507. E-mail ehavrane@dhha.org

The Canadian Cardiovascular Society Severity in Atrial Fibrillation (CCS-SAF) scale described in the report by Dorian et al¹ in this issue of Circulation: Arrhythmia and Electrophysiology is worthy of our attention because it offers us something we can use. It also serves a deeper purpose and offers us somethingwe should use.
It is of use because it gives us a simple and reliable tool to use at the bedside to understand patients’ experiences with atrial fibrillation. We have scales that assess patient’s overall health status (so-called generic questionnaires), the most widely used of which is the SF-36 questionnaire. The SF-36 has been used previously to assess health status in a number of studies of atrial fibrillation.² Its length, however, limits its use in everyday clinical practice. A shorter version (the SF-12) is available, but it is not clear if this questionnaire is able to separate the impact of atrial fibrillation from the burden of comorbidity that is the lot of the typical patient.We also have questionnaires specific for atrial fibrillation.^3–5 Although they might be able to dissect the impact of atrial fibrillation from that of comorbidity, they have not been widely used and are too long for bedside use.

Scales useful at the bedside have characteristics in common. They combine data from a large enough number of variables to provide adequate discrimination yet from a small enough number of variables to allow commitment to memory—usually 3 to 5./.../