Table 3. Analysis of AF-Specific Classification Tools/Symptom Scales.
*Authors were unable to determine validation strategies or recall lengths for the AFSS and SCL. §EHRA: European Heart Rhythm Association Classification. mEHRA: Modified European Heart Rhythm Association Classification. CCS-SAF: Canadian Cardiovascular Society Symptoms Severity in Atrial Fibrillation. AFSS: Atrial Fibrillation Symptom Severity. SCL: Symptom Checklist. AFS/B: Atrial Fibrillation Symptom and Burden.
| Classification Tool/Symptom Scale | Patient or Provider Completed? | Classifications or Scoring Method | Length of Recall Period | Validation Strategy | Specific Advantages |
|---|---|---|---|---|---|
| EHRA[47] | Provider | -4 total classifications -Patients classified based on AF’s impact on ability to complete daily activities |
-Immediate Assessment | -Validated against AFEQT and EQ-5D | -Simple classification system for efficient bedside use |
| mEHRA[46] | Provider | -5 total classifications -Patients classified based on AF’s impact on ability to complete daily activities -Subset of patients scored based on “troublesome” nature of symptoms |
-Immediate Assessment | -Validated against AFEQT and EQ-5D | -Increased granularity compared to standard EHRA |
| CCS-SAF[48] | Provider | -5 total classifications -Patients classified based on symptom’s perceived impact on overall HRQOL |
-Immediate Assessment | -Validated against SF-36 and AFSS | -More detailed classifications as compared to EHRA/mEHRA -Assesses symptom severity with respect to HRQOL |
| AFSS[50] | Patient | -14 total questions assessing symptom severity, frequency, and duration -Objective and subjective measure of AF symptom impact |
- | - | -Patient -reported outcome measure |
| SCL[51] | Patient | -Separate assessments of symptom severity and burden. -Higher scores indicate more frequent/severe symptoms |
- | - | -Patient -reported outcome measure |
| AFS/B[52] | Patient | -4 classifications of symptom and burden severity -14 total questions: Eight focus on symptoms in daily life, six focus on AF frequency, duration, and healthcare use |
-Current Status | -Validated against SF-12 (V2) | -Both patient and provider complete instrument. |