on March 31, 2009
Published online before print March 31, 2009, doi: 10.1161/CIRCEP.108.812347
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Original Article |
Validation of a New Simple Scale to Measure Symptoms in Atrial Fibrillation: The Canadian Cardiovascular Society Severity in Atrial Fibrillation (CCS-SAF) Scale
1 St. Michael's Hospital and the University of Toronto;
2 Montral Heart Institute and the Université de Montréal;
3 St. Paul's Hospital and the University of British Columbia;
4 Sunnybrook and Women's College Health Sciences Centre and the University of Toronto;
5 Libin Cardio Inst of Alberta; Calgary Health Reg; U of Calgary; Alberta Heritage Found for Med Res;
6 Libin Cardiovascular Institute of Alberta, Calgary Health Region and the University of Calgary;
7 London Health Sciences Centre and the University of Western Ontario;
8 Calgary Health Region
9 E-mail: dorianp{at}smh.toronto.on.ca
Background—Atrial fibrillation (AF) is commonly associated with impaired quality of life. There is no simple validated scale to quantify the functional illness burden of AF. The Canadian Cardiovascular Society Severity in Atrial Fibrillation Scale (CCS-SAF) is a bedside scale, which ranges from Class 0 - 4, from no effect on functional quality of life to a severe effect on life quality. This study was performed to validate the scale.
Methods and Results—In 484 patients with documented AF; (62.2±12.5 years of age, 67% male; 62% paroxysmal and 38% persistent/permanent ), the SAF Class was assessed and two validated quality of life questionnaires were administered: the SF-36 generic scale and the disease specific AFSS (University of Toronto Atrial Fibrillation Severity Scale). There is a significant linear graded correlation between the SAF Class and measures of symptom severity, physical and emotional components of quality of life, general well-being and health care consumption related to atrial fibrillation. Patients with SAF Class 0 had age and sex standardized SF-36 scores of 0.15±0.16 and -0.04±0.31 (SD units) ie. units away from the mean population score for the mental and physical summary scores, respectively. For each unit increase in SAF Class, there is a 0.36 and 0.40 SD unit decrease in the SF-36 score for the physical and mental components. As the SAF Class increases from 0 to 4, the symptom severity score (range 0 - 35) increases from 4.2±5.0 to 18.4±7.8 (p < 0.0001).
Conclusions—The CCS-SAF scale is a simple semi-quantitative scale that closely approximates patient reported subjective measures of quality of life in AF and may be practical for clinical use.
Key Words: Atrial Fibrillation • Quality of Life
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