Depression, Anxiety, and Quality of Life After Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Abstract

Background: Patients with paroxysmal atrial fibrillation (AF) experience impaired quality of life (QoL) and psychological distress. Catheter ablation of AF can markedly improve QoL. However, the effect of catheter ablation of AF on psychological status is unknown. Hypothesis: Depression, anxiety, and QoL improve after catheter ablation in patients with paroxysmal AF. Methods: A total of 166 consecutive patients with symptomatic paroxysmal AF were examined. Eighty-two patients (55 men, mean age 55.9 ± 6.1 y) underwent catheter ablation and 84 patients (58 men, mean age 57.2 ± 5.4 years) received antiarrhythmic drug (AAD) therapy. The Self-Rating Depression Scale, Self-Rating Anxiety Scale, and Medical Outcomes Survey 36-item Short-Form questionnaires were completed by these patients at baseline, and at 3, 6, 9, and 12 months of follow-up. Results in the ablation group were compared with those of the AAD group. Results: In the ablation group, 42.7% of patients showed symptoms of depression and 37.8% showed symptoms of anxiety, which were similar to those in the AAD group. Both groups similarly displayed reduced physical and mental QoL. Catheter ablation was effective in reducing symptoms of depression and anxiety and improving QoL, and it was superior to AAD therapy (all P < 0.001). Multiple regression analysis demonstrated that catheter ablation, no AF recurrence, avoidance of warfarin use, higher baseline depression and anxiety scores, and lower baseline QoL scores contributed to improvement of depression, anxiety, and QoL, respectively. Conclusions: Catheter ablation is more effective for improving depression, anxiety, and QoL in patients with paroxysmal AF compared with AAD therapy.

Does Type D Personality Impact on the Prognosis of Patients Who Underwent Catheter Ablation for Atrial Fibrillation? A 1-Year Follow-Up Study

“…Catheter ablation is effective for improving depression, anxiety, and QoL in patients with AF 35. Similarly, our results showed that depression, anxiety and poor QoL were improved 6 months after RFCA.…”

“…In addition, all patients included in this study were treated with catheter-based ablation therapy, which contributed to the homogeneity of our sample. However, according to current guidelines for the AF, ablation therapy is recommended as the secondary treatment for patients who are not able to tolerate drugs or who fail the first-line treatment 3435. Thus, the clinical characteristics of our sample may be attributable to the dissociation between personality type and the recurrence of AF.…”

A Systematic Review of Depression and Anxiety in Patients with Atrial Fibrillation: The Mind-Heart Link

“…They reported that catheter ablation was effective in reducing symptoms of depression and anxiety and improving quality of life, and it was superior to antiarrhythmic drug therapy [35]. …”

Comparison of Changes in Anxiety and Depression Level Between Dabigatran and Warfarin Use in Patients With Atrial Fibrillation

“…19 Sang et al demonstrated that contributors to the improvement of depression, anxiety, and QoL included catheter ablation, avoidance of warfarin use, initial higher levels of depression and anxiety, and lower QoL. 20 Outpatients undergoing warfarin therapy had a significantly higher risk for death if they were burdened with symptoms of depression or anxiety showed in a very recent study. 21 Previous data have been conflicting on whether a positive impact on QoL from oral anticoagulant therapy or high levels of displeasure with OAC therapy perhaps associated with poor therapeutic control.…”