Atrial fibrillation and psychological factors: a systematic review

Abstract

BackgroundPsychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression.MethodsA systematic electronic search had been conducted to identify studies exploring different psychological factors in AF. The search retrieved 832 articles that were reviewed according to inclusion criteria: observational study with a control/comparison group; use of standardized and validated instruments for psychological assessment. Results were summarized qualitatively and quantitatively by effect size measure (Cohen’s d and its 95% confidence interval). Cochrane Collaboration guidelines and the PRISMA Statement were adopted.ResultsEight studies were included in the systematic review. Depression was the most studied construct/ but only one study showed a clear link with AF. The remaining studies showed small and non-significant (95% CI [−0.25–1.00]) differences between AF and controls, no differences in frequency of depression history (95% CI [−0.14–0.22]) or in case frequency (95% CI [−0.50–0.04]). Miscellaneous results were found as far as anxiety: AF patients showed higher levels when compared to healthy subjects (95% CI [2.05–2.95]), but findings were inconsistent when compared to other heart diseases. Considering personality and life-events preceding AF, we respectively found a large (95% CI [1.87–2.49]) and a moderate to large effect (95% CI [0.48–0.98]).DiscussionThe small number of studies does not allow to draw clear-cut conclusions on the involvement of psychological factors in AF. Promising lines of research are related to personality and adverse life-events, and to the increase of longitudinal design studies. Some methodological problems could be overcome by including clinical psychologists in the implementation of research protocols.

Anxiety and Depression in Patients with Permanent Atrial Fibrillation: Prevalence and Associated Factors

“…Atrial fibrillation (AF) is the most common heart arrhythmia in clinical practice which is expected to increase dramatically within next decades due to the prolongation of life expectancy and the improvements in diagnosis [ 1 ]. According to estimates, AF currently affects over 6 million patients in Europe and approximately 2.3 million in the United States [ 2 ].…”

Traumatic Events, Personality and Psychopathology in Takotsubo Syndrome: A Systematic Review

“…Depression and anxiety have been associated not only with TTS (Nayeri et al, 2018), but also with elevated risk of developing other cardiac diseases (Janszky et al, 2007;Kendler et al, 2009;Gustad et al, 2014;Galli et al, 2017). A recent retrospective cohort study (Nayeri et al, 2018) found that preexisting psychopathologic disorders (anxiety, mood disorders, and schizophrenia) were associated with an increased risk of recurrent TTS, but not to survival.…”

Failure of the Anticoagulant Therapy and Psychological Distress: Still Far From a Bridge

“…Atrial fibrillation (AF) is a common disorder of cardiac rhythm (estimated prevalence in people older than 15 years in Italy is 2% ( Zoni-Berisso et al, 2013 ) that increases with age. Psycho-emotional factors seem to be associated to AF in different ways ( Galli et al, 2017 ). AF predisposes to arterial thrombosis and systemic embolism, the reason why patients need long-term antithrombotic prophylaxis with oral anticoagulants (OACs), as vitamin K antagonists (VKAs).…”