Quality of Life Experiences among Women with Atrial Fibrillation: Findings from an Online Survey.

BACKGROUND: Although atrial fibrillation (AF) is the most common abnormal heart rhythm in men and women, there are gender differences. Mortality for women with AF can be 2.5 times greater than for men. AF risk among women is also greater than in men when patients have additional conditions. Women are more likely to experience longer symptomatic episodes, more recurrences, and higher ventricular rates during AF. We sought to explore presentation, comorbidities, treatment, and quality-of-life issues among women with AF. METHODS: A convenience sample of 332 women with AF completed a 58-item online survey fielded for 2 weeks in April 2015. RESULTS: Of the respondents, 94% were Caucasian; 76% consumed four or fewer servings of fruits or vegetables per day; 43% engaged in moderate physical activity for 10 minutes 3 or fewer days per week; 41% had a body mass index (BMI) of greater than 30 kg/m(2); and 85% had never attended an AF support group. Women with AF often juggle many health conditions. Almost none had participated in an AF clinical trial. The ability to complete activities of daily living was associated significantly and positively with fruit/vegetable consumption and physical activity and significantly and negatively associated with BMI. Self-efficacy was associated significantly with physical activity and support group attendance. Open-ended comments showed many women patients have outstanding questions about their AF. CONCLUSIONS: AF education resources should underscore the positive physical and mental health effects of increasing fruit/vegetable consumption and physical activity. Caregivers, clinicians, and women with AF need to be made aware of the benefits of support groups, whether in-person or online, and clinical trials. Future research should engage in effective recruitment of non-White women with AF.

Medication adherence, cascade screening, and lifestyle patterns among women with hypercholesterolemia: Results from the WomenHeart survey.

BACKGROUND: Hypercholesterolemia is a major risk factor for cardiovascular disease. Women with hypercholesterolemia and familial hypercholesterolemia (FH) are a high-risk group often underdiagnosed, undertreated, and unaware of the need for cascade screening. OBJECTIVES: The objectives were to identify the prevalence of hypercholesterolemia and FH in 2 national databases, explore lifestyle/medication adherence, and examine rates of cascade screening (lipid testing in all first-degree relatives) among those with FH. METHODS: This was a cross-sectional study of women who completed an online survey in 2014. Outcomes were examined for 3 groups: diagnosed, probable, and no FH. For FH, multivariable logistic regression was used to examine the association between family member screening for FH and sociodemographic and/or clinical characteristics. RESULTS: There were 761 respondents with a mean (±standard deviation) age of 59 ± 10.1 years; 26% reported FH, 22% probable FH, and 51% no FH. Eighty-three percent of the total sample and 95% with FH take a statin. In those with hypercholesterolemia and FH, 65% and 58% reported high medication adherence, respectively. Women with probable FH consumed significantly fewer fruits/vegetables and were less active. FH cascade screening was: siblings 54%, parents 37%, and children 34%. Marital status, annual household income, and diabetes were significantly associated with cascade screening. CONCLUSION: In a survey of informed women with hypercholesterolemia and FH, cascade screening is underused. Our findings warrant increased efforts to identify cascade screening barriers. Early detection and treatment of hypercholesterolemia/FH is a priority for women, and their first-degree relatives, as this may dramatically reduce cardiovascular disease impact.

Assessment of the quality of existing patient educational tools focused on sudden cardiac arrest: a systematic evaluation by the Sudden Cardiac Arrest Thought Leadership Alliance.

BACKGROUND: Conveying contemporary treatment options for those at risk of sudden cardiac arrest (SCA) is challenging. The purpose of the present research was to evaluate the quality and usability of available patient educational tools relevant to SCA and its treatment options, such as implantable cardioverter defibrillators (ICDs). We hypothesized that this review would identify gaps in areas of information for the enhancement of patient education and decision-making materials. METHODS: We used a formal instrument to assess specific domains of content, development, and effectiveness of 18 available SCA and ICD educational tools. The multidisciplinary review panel included two electrophysiologists, two general cardiologists, a cardiac psychologist, a health services researcher, and a patient advocate. RESULTS: Of the 18 education tools, four were rated as "good, may need revisions, but sufficient for use", 12 were rated as "marginal, needs revision prior to use", and two were rated as "poor, inadequate for use". None of the tools were rated as being of "very good" or "excellent" quality. CONCLUSION: There appear to be opportunities to improve the quality and completeness of existing educational tools for patients with SCA and ICD. While many tools have been developed, they fall below current standards for supporting informed medical decision-making.