Key result
Suspected depression in AF is linked to ~22-point lower disease-specific quality of life scores.
Why the study?
A reciprocal association between AF and depression has been proposed, but depression is frequently underdiagnosed in cardiology practice.
Is suspected depression prevalent in patients with atrial fibrillation and is it associated with reduced quality of life and handgrip strength?
Cross-Sectional (n=100)
No
Is suspected depression prevalent in patients with atrial fibrillation and is it associated with reduced quality of life and handgrip strength?
Absolute Event Rate: 49.1% vs 71.3%
p-value: p=< 0.001
Unrecognized depressive symptoms are highly prevalent in patients with atrial fibrillation and are significantly associated with reduced disease-specific quality of life.
Suspected depression warrants screening consideration in atrial fibrillation; cross-sectional data leave open causal effects on quality of life.
BACKGROUND: A reciprocal association of atrial fibrillation (AF) and depression has been proposed, but depression is often underdiagnosed in cardiology. We assessed the prevalence of suspected depression in a consecutive cohort of patients with AF examined its association with disease-related quality of life (QoL) and handgrip strength. METHODS: In this single-center cross-sectional study of a prospectively recruited consecutive cohort of patients with documented AF, 100 patients completed the AF Effect On Quality-Of-Life Questionnaire (AFEQT) questionnaire. The Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) was used to scale suspected depression severity. Handgrip strength was measured using a hydraulic handgrip dynamometer. A multivariable linear regression analysis for reduced handgrip was performed and associations between AFEQT, PHQ-9 and MADRS were assessed via Spearman correlation analysis. RESULTS: Depressive symptoms were found in 53% of patients on at least one screening tool, and 30% met criteria in both PHQ-9 and MADRS. Most cases (79.3%) represented new suspected diagnoses. Patients with suspected depression had lower AFEQT scores (49.1 points [38.5-65.7]) compared to those without (71.3 points [59.3-88.0], p < 0.001). The AFEQT overall score moderately correlated with PHQ-9 (r = -0.534, p < 0.001) and MADRS (r = -0.410, p < 0.001). Handgrip strength did not differ between groups but was independently associated with older age (B = -0.47, p < 0.001), female sex (B = -12.5, p < 0.001), and higher MADRS scores (B = -0.40, p = 0.012), R = 0.773. Among patients with suspected depression, 28% indicated willingness to use a mental health app, with higher acceptance in those <70 years. CONCLUSION: Previously unrecognized depressive symptoms are highly prevalent and often newly detected in patients with AF, with a significant negative association with disease-specific QoL. Routine screening with validated tools should be integrated into cardiology practice to enable timely diagnosis and comprehensive psycho-cardiological management.
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Walter et al. (2026) conducted a cross-sectional in Atrial fibrillation (n=100). Suspected depression vs. No suspected depression was evaluated on AFEQT scores (disease-related quality of life) (p=< 0.001). Suspected depression in patients with atrial fibrillation was associated with significantly lower disease-specific quality of life scores (49.1 vs 71.3 points, p < 0.001).
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