Key result
Lower baseline mental health scores (53.2 vs 69.7, P=0.001) and higher anxiety and depression scores significantly predicted atrial fibrillation recurrence after pulmonary vein antral isolation.
Why the study?
Do baseline quality of life, anxiety, and depression metrics predict atrial fibrillation recurrence following pulmonary vein antral isolation in patients with paroxysmal AF?
Cohort (n=57)
Do baseline quality of life, anxiety, and depression metrics predict atrial fibrillation recurrence following pulmonary vein antral isolation in patients with paroxysmal AF?
Answers are grounded in this paper and cite their sources.
Worse baseline mental health, anxiety, and depression are significant independent predictors of AF recurrence following pulmonary vein isolation, although ablation itself significantly improves these psychological parameters.
BACKGROUND: Atrial fibrillation (AF) is associated with significant impairment of quality of life (QoL). Anxiety and depression are common in AF patients and might predispose to AF. We sought to investigate associations of preablative QoL and stress parameters with AF ablation outcomes, as well as possible changes in QoL, anxiety, and depression parameters after ablation. METHODS: A total of 57 consecutive patients with paroxysmal AF underwent pulmonary vein (PV) antral isolation. The Short-Form Life Survey-36 items (SF-36), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI) were assessed before and at 6 months after ablation. RESULTS: After a mean follow-up of 8.0 ± 2.5 months, 41 patients (71.9%) remained free from arrhythmia. Baseline mental health summary QoL SF-36 score was significantly lower in patients with AF recurrence (53.2 ± 10.3 vs 69.7 ± 17.9; P = 0.001), while the physical health summary score did not differ significantly between patients with and without recurrence. Patients with recurrence had higher baseline STAI-trait (41.9 ± 1.5 vs 34.7 ± 4.9) and BDI (17.3 ± 9.7 vs 5.4 ± 3.0) scores (P < 0.001 for both). In multivariable analysis, SF-36 mental health summary, STAI-trait, and BDI scores remained significant predictors of recurrence after adjustment for age, gender, body mass index, diabetes, and hypertension. Mental and physical domain SF-36 summary scores were significantly improved 6 months after ablation (P = 0.001) and a significant reduction in symptoms of depression (P = 0.001) and anxiety (P = 0.001) was observed. CONCLUSIONS: Baseline QoL, anxiety, and depression metrics were associated with AF recurrence following PV antral isolation. Furthermore, there was a significant improvement in QoL, anxiety, and depression after left atrial ablation.
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Efremidis et al. (2014) conducted a cohort in Paroxysmal atrial fibrillation (n=57). Baseline anxiety, depression, and impaired quality of life vs. Normal baseline psychological metrics was evaluated on Atrial fibrillation recurrence (p=<0.001). Lower baseline mental health scores (53.2 vs 69.7, P=0.001) and higher anxiety and depression scores significantly predicted atrial fibrillation recurrence after pulmonary vein antral isolation.
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