OBJECTIVES: To assess the impact of symptoms in patients with Atrial Fibrilation (AF) through AF-QoL, a specific questionnaire to measure Health Related Quality of Life (HRQoL). METHODS: Observational cross-sectional study in cardiologist setting. Patients included were >18 years old with paroxystic AF (AFPar) or persistent AF (AFPer). Main clinical variables: type of AF, NYHA functional stage, symptoms frequency and duration and CHADS2 index. AF-QoL has 18 items and 3 domains: psychological, physical and sexual activity, and scores standardized between 0 (worst HRQoL) and 100 (best HRQoL). RESULTS: A total of 824 patients were included: 513 (62.3%) with AFPar and 311 (37.7%) with AFPer. 56.1% were male and mean (SD) age was 68.2 (11.3) years. Patients with AFPar were younger than AFPer (p<0.001). 82.8% and 26.1% of patients with AFPar had palpitations and dyspnea vs. 62.4% and 44.7% of AFPer (p<0.001). AFPar was associated to higher thromboembolism risk by CHADS2 (p<0.001). Global mean (SD) score for AF-QoL was similar between both types of AF: 51.23 (23.76) in AFPar and 46.68 (24.48) in AFPer, but differences were observed in physical domain having AFPar a higher mean score that AFPer (p=0.003). Multivariate analysis showed that being male, having  presence of mild or no symptoms, practicing exercise, having NYHA stage I and II and not having emergency visits was related with higher score of HRQoL (R2=0.32; p<0.0001). CONCLUSIONS: AF symptoms have a high impact in HRQoL of patient. Therapies able to reduce severity of symptoms and number of emergency visits will have a positive impact on HRQoL in patients with AF.