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November 7, 2025Frontiers in Cardiovascular Medicine0 citationsOpen Access

Core and bridging symptoms in patients with atrial fibrillation: a network analysis

DSDingce SunXYXue YangHLHong Li

Key Result

Shortness of breath during physical activity and at rest were identified as core symptoms in patients with atrial fibrillation, while shortness of breath at rest, palpitations, and chest pain served as bridging symptoms.

Study Design

Type

Cross-Sectional (n=384)

Multicenter

No

Structured PICO

P
Population
384 patients with non-valvular atrial fibrillation were evaluated in a cross-sectional study to identify core and bridging symptoms using network analysis.
O
Outcome
Symptom network characteristics, core and bridging symptomspatient reported

Network analysis identifies shortness of breath as a core symptom in atrial fibrillation, providing potential targets for symptom management.

Limitations

  • Single-center investigation with a small sample size, limiting generalizability
  • Cross-sectional design reduces the strength of evidence regarding relationships between atrial fibrillation symptoms and other factors
  • Use of convenience sampling may have introduced selection bias

Abstract

Background: Atrial fibrillation symptoms are diverse and complex, but symptom networks can visually map the relationships between symptoms and influencing factors, identifying key symptoms and offering better targets for symptom management. However, research on establishing symptom networks in Atrial fibrillation patients is limited. Aim: We aimed to construct a symptom network for patients with atrial fibrillation, understand its characteristics, and identify core and bridging symptoms. Methods: This cross-sectional study enrolled 384 patients with atrial fibrillation from November 2021 to August 2022 at Tianjin Medical University General Hospital of China. Network analysis methods were utilized to construct the symptom network. Centrality metrics were used to identify important symptoms. Results: By incorporating covariates into the symptom network, we revealed that the Mental Health Inventory-5 score was most closely related to "fatigue at rest". Sex influenced all symptoms except "dizziness" and "shortness of breath at rest". Left ventricular ejection fraction was closely connected to "exercise intolerance" and "shortness of breath at rest", while the frail score was closely linked to "exercise intolerance" and "dizziness". Controlling for covariates, "shortness of breath during physical activity" and "shortness of breath at rest" are atrial fibrillation patients' core symptoms. "Shortness of breath at rest", "palpitations", and "chest pain" served as bridging symptoms between symptom clusters. Conclusion: Symptom networks can help us understand the relationships between symptoms and influencing factors, as well as the interactions between different atrial fibrillation symptoms.

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Cite This Study

Sun et al. (2025) conducted a cross-sectional in Atrial fibrillation (n=384). Clinical and demographic factors (mental health, sex, LVEF, frailty) was evaluated on Core and bridging symptoms identified via network analysis. Shortness of breath during physical activity and at rest were identified as core symptoms in patients with atrial fibrillation, while shortness of breath at rest, palpitations, and chest pain served as bridging symptoms.

synapsesocial.com/papers/6a5c73d5761fee6e4b030fc5https://doi.org/10.3389/fcvm.2025.1617872
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Symptom Network and Clusters of the Multidimensional Symptom Experience in Patients With Atrial Fibrillation2024 · 6 citations
  2. 2Relationships between Symptom Group and Quality of Life in Patients with Atrial Fibrillation: A Cross-Sectional Study2023
  3. 3Symptom Clusters, Psychological Distress, and Quality of Life in Patients with Atrial Fibrillation2023 · 10 citations
  4. 4Atrial fibrillation symptom clusters and associated clinical characteristics and outcomes: A cross-sectional secondary data analysis2018 · 40 citations
  5. 5Symptom Burden of Atrial Fibrillation and Its Relation to Interventions and Outcome in Europe2018 · 44 citations