Effect of Anxiety and Depression on the Recurrence of Paroxysmal Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Effect of Anxiety and Depression on the Recurrence of Paroxysmal Atrial Fibrillation. Introduction: Whether circumferential pulmonary vein ablation (CPVA) can alleviate anxiety and depression symptoms is unknown and the effect of anxiety and depression on the recurrence of atrial fibrillation (AF) after CPVA is not clear. Methods: Two hundred and ten patients with a diagnosis of paroxysmal AF were admitted in the study. Ninety-eight patients (CPVA group) and 102 patients (medicine group) were treated with CPVA and antiarrhythmic drugs, respectively. All patients were followed up for 1 year. Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and Short-Form life survey-36 items (SF-36) were assessed before and after follow-up. Results: In CPVA group, the scores of SAS and SDS decreased (41.69 +/- 8.32 vs 37.66 +/- 4.82, P < 0.001 and 45.01 +/- 9.71 vs 40.05 +/- 8.56, P < 0.001, respectively) and SF-36 score improved (565.29 +/- 143.37 vs 606.84 +/- 102.84, P = 0.021) after follow-up. Compared with the data in recurrent patients, the SAS and SDS scores were significantly lower in nonrecurrent patients at baseline (44.68 +/- 8.40 vs 38.10 +/- 7.55, P < 0.001 and 51.75 +/- 9.41 vs 43.96 +/- 8.95, P < 0.001, respectively). The results of multivariate logistic regression analysis showed normalized scores of SAS (OR = 3.20, 95% CI [3.05, 3.48], P = 0.023) and SDS (OR = 3.26, 95% CI [3.12, 3.49], P = 0.023) were the independent risk factor of AF recurrence after CPVA. Conclusions: CPVA can ameliorate anxiety and depression, which may contribute to improvement of quality of life in patients with paroxysmal AF. Anxiety and depression increase the recurrence risk of AF after CPVA. (J Cardiovasc Electrophysiol, Vol. 23, pp. S17-S23, November 2012)