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The Impact of Psychological Distress on Atrial Fibrillation

The Impact of Psychological Distress on Atrial Fibrillation

Atrial fibrillation (AF) is the most common arrhythmia in adults and is rapidly reaching epidemic proportions in the United States. Recent studies have suggested that treatment of AF correlates with enhanced overall quality of life. According to current guidelines, the choice of management strategy for AF should be guided by the symptomatic status of patients due to AF. Despite the emphasis being placed on relief of AF symptoms, several smaller investigations have suggested that psychological distress may be linked with patient-reported AF symptom severity. Some analyses have shown that patients with AF have a high prevalence of anxiety and depression. It’s possible that depression and anxiety may be more important than the number or duration of AF episodes in predicting AF symptom severity. These conditions may also be important predictors of worsened outcomes in patients with AF. Few studies, however, have investigated the association between anxiety and depression and severity of symptoms that patients attribute to AF. Intriguing New Data on Patients with Atrial Fibrillation To determine whether psychological distress is an important factor in patient-reported AF symptom severity, my colleagues and I performed a study—published in the Journal of Cardiovascular Electrophysiology—that examined the issue in greater detail. A cohort of 300 outpatients with stable AF was screened for symptoms of anxiety, depression, and somatization disorder. They also completed questionnaires that assessed general health and well-being, specifically measuring disease-specific AF symptom severity. Overall, patients in the study with worsened severity of depression, anxiety, or somatization disorder symptoms had an increase in AF symptom severity regardless of the AF severity scale used (see Figure). In addition, greater severity of depression...
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