Pavlicek Valérie, Wedegärtner Sonja Maria, Millenaar Dominic, Wintrich Jan, Böhm Michael, Kindermann Ingrid, Ukena Christian
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, D-66421 Homburg, Germany.
J Clin Med. 2022 Mar 22;11(7):1751. doi: 10.3390/jcm11071751.
(1) Background: Atrial fibrillation (AF) is associated with anxiety, depression, and chronic stress, and vice versa. The purpose of this study was to evaluate potential effects of pulmonary vein isolation (PVI) on psychological factors. (2) Methods: Psychological assessment was performed before PVI as well as after six months. (3) Results: A total of 118 patients [age 64 ± 9 years, 69% male, left ventricular ejection fraction 57 ± 8%, 56% paroxysmal AF] undergoing PVI were included. After PVI, significant improvements were observed in the mean total heart-focused anxiety (HFA) score, as well as in the Cardiac Anxiety Questionnaire (CAQ) sub-scores: HFA attention, HFA fear, and HFA avoidance scores. Subgroup analyses showed an association of improvement with freedom of documented AF recurrence. Mean scores of general anxiety and depression evaluated by the Hospital Anxiety and Depression Scale (HADS) decreased significantly after PVI in all subgroups regardless of AF recurrence. Further, both physical and mental composite scores of the Short Form Health Survey (SF-12) increased significantly from baseline. (4) Conclusions: PVI results in a significant reduction in HFA. Improvements in general anxiety and depressive symptoms did not seem to be related only to rhythm control per se. Therefore, CAQ may represent a more specific evaluation tool as HADS in patients with AF.
(1) 背景：心房颤动（AF）与焦虑、抑郁和慢性应激相关，反之亦然。本研究的目的是评估肺静脉隔离（PVI）对心理因素的潜在影响。(2) 方法：在PVI前以及六个月后进行心理评估。(3) 结果：纳入了118例行PVI的患者[年龄64±9岁，69%为男性，左心室射血分数57±8%，56%为阵发性AF]。PVI后，平均总心脏聚焦焦虑（HFA）评分以及心脏焦虑问卷（CAQ）子评分：HFA注意力、HFA恐惧和HFA回避评分均有显著改善。亚组分析显示改善与记录的房颤复发自由度相关。无论房颤复发情况如何，所有亚组中通过医院焦虑抑郁量表（HADS）评估的一般焦虑和抑郁平均评分在PVI后均显著降低。此外，简明健康调查（SF - 12）的身体和心理综合评分均较基线显著提高。(4) 结论：PVI导致HFA显著降低。一般焦虑和抑郁症状的改善似乎并非仅与节律控制本身有关。因此，在房颤患者中，CAQ可能是一种比HADS更具特异性的评估工具。
