Exploring Depressive Symptoms and Anxiety Among Patients With Atrial Fibrillation and/or Flutter at the Time of Cardioversion or Ablation.
Exploring Depressive Symptoms and Anxiety Among Patients With Atrial Fibrillation and/or Flutter at the Time of Cardioversion or Ablation.
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DOI：
10.1097/jcn.0000000000000723
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发表时间：
2021-09-01
影响因子：
2
通讯作者：
Bakken, Suzanne
中科院分区：
文献类型：
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作者：
Koleck, Theresa A.;Mitha, Shazia A.;Biviano, Angelo;Caceres, Billy A.;Corwin, Elizabeth J.;Goldenthal, Isaac;Creber, Ruth Masterson;Turchioe, Meghan Reading;Hickey, Kathleen T.;Bakken, Suzanne
心房颤动（和/或心房扑动）患者的抑郁和焦虑可能影响心律转复和消融的有效性。在进行这些治疗时，缺乏与抑郁症状和焦虑相关的知识。我们的目的是描述AF患者在心律转复或消融时抑郁症状和焦虑的患病率，并探讨潜在的协变量。我们进一步探讨抑郁症状和焦虑对手术时生活质量和6个月房颤复发的影响。使用患者健康问卷-9、状态-特质焦虑量表和心房颤动对生活质量的影响问卷收集转复或消融时的抑郁症状、焦虑和生活质量。评估术后6个月内房颤复发的情况。参与者（N=171）年龄为61.20±11.23岁，主要为男性（80.1%）和白人，非西班牙裔（81.4%）。中度至重度抑郁症状（17.2%）、临床显著状态（30.2%）和特质性焦虑（23.6%）。情绪/焦虑障碍诊断与所有三种症状相关。AF症状严重程度与抑郁症状和特质焦虑相关。心衰诊断和地高辛的使用也与抑郁症状有关。观察状态焦虑和特质焦虑与参与者种族/民族、抑郁症状和体重指数之间的显著性趋势。研究结果支持症状与生活质量之间的联系，但不支持6个月房颤复发。抑郁症状和焦虑在房颤患者中很常见。医疗保健提供者应在手术时监测房颤患者的抑郁症状和焦虑，并在有指示时进行干预。对房颤患者抑郁症状和焦虑的评估、预测、治疗和结果的进一步调查是有必要的。
Depression and anxiety in patients with atrial fibrillation (and/or atrial flutter; AF) may influence the effectiveness of cardioversion and ablation. There is a lack of knowledge related to depressive symptoms and anxiety at the time of these procedures. We aimed to describe the prevalence and explore potential covariates of depressive symptoms and anxiety in patients with AF at the time of cardioversion or ablation. We further explored the influence of depressive symptoms and anxiety on quality of life at the time of procedure and 6-month AF recurrence. Depressive symptoms, anxiety, and quality of life were collected at the time of cardioversion or ablation using the Patient Health Questionnaire-9, State-Trait Anxiety Inventory, and Atrial Fibrillation Effect on Quality of Life questionnaire. Presence of AF recurrence within 6-months post-procedure was evaluated. Participants (N=171) were x̄=61.20±11.23 years of age, primarily male (80.1%), and white, non-Hispanic (81.4%). Moderate to severe depressive symptoms (17.2%) and clinically significant state (30.2%) and trait (23.6%) anxiety were reported. Mood/anxiety disorder diagnosis was associated with all three symptoms. AF symptom severity was associated with both depressive symptoms and trait anxiety. Heart failure diagnosis and digoxin use were also associated with depressive symptoms. Trends towards significance between state and trait anxiety and participant race/ethnicity as well as depressive symptoms and body mass index were observed. Study findings support associations between symptoms and quality of life, but not 6-month AF recurrence. Depressive symptoms and anxiety are common in patients with AF. Healthcare providers should monitor AF patients for depressive symptoms and anxiety at the time of procedures and intervene when indicated. Additional investigations on assessment, prediction, treatment, and outcome of depressive symptoms and anxiety in patients with AF are warranted.