Anthony Scarlett, Harrell Rebecca, Martin Caroline, Hawkins Taylor, Khan Saleen, Naniwadekar Aditi, Sears Samuel F
Department of Psychology, East Carolina University, Greenville, NC, United States.
Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, United States.
Front Psychiatry. 2022 Jul 4;13:915327. doi: 10.3389/fpsyt.2022.915327. eCollection 2022.
Atrial fibrillation occurs when rapid and disorganized electrical signals cause the atria in the heart to beat irregularly and is associated with an increased risk for stroke. Despite medical advancements, first and second line atrial fibrillation treatments exhibit significant recurrence rates. Because of this, atrial fibrillation patients often experience disease-specific fears that are not routinely assessed and targeted in clinical management. Fear of recurrence models in cancer research and other cardiac-specific fears have paved the way for a patient-centric approach to disease intervention.
Clinical assessment focused solely on the taxonomy of anxiety disorders may miss key components unique to the atrial fibrillation patient experience. An anxiety disorder diagnosis in the presence of an arrhythmia could be misleading and ultimately fail to address patient needs. Modeled from the cancer literature, providers may benefit from a broader disease specific conceptualization for AF patients that differs from a general DSM-5 diagnosis.
The objectives of this paper are: (1) to review the medical aspects of atrial fibrillation, (2) to examine the comparability of fear of recurrence concept from cancer literature to the atrial fibrillation patient, and (3) to suggest considerations of these novel concepts in patient care.
Increased understanding of fear of recurrence among atrial fibrillation patients aims to define and assess fear of recurrence components, determine treatment targets, and ultimately improve patient outcomes.
当快速且紊乱的电信号导致心脏心房不规则跳动时，就会发生心房颤动，且其与中风风险增加相关。尽管医学取得了进步，但一线和二线心房颤动治疗的复发率仍很高。因此，心房颤动患者常常会经历一些特定疾病的恐惧，而这些恐惧在临床管理中并未得到常规评估和针对性处理。癌症研究中的复发恐惧模型以及其他特定心脏疾病的恐惧为以患者为中心的疾病干预方法铺平了道路。
仅专注于焦虑症分类的临床评估可能会忽略心房颤动患者经历中独特的关键组成部分。在存在心律失常的情况下进行焦虑症诊断可能会产生误导，最终无法满足患者需求。借鉴癌症文献，医疗服务提供者可能会从针对心房颤动患者的更广泛的疾病特定概念化中受益，这与一般的《精神疾病诊断与统计手册》第5版（DSM-5）诊断不同。
本文的目标是：（1）回顾心房颤动的医学方面；（2）研究癌症文献中复发恐惧概念与心房颤动患者的可比性；（3）提出在患者护理中考虑这些新概念的建议。
加深对心房颤动患者复发恐惧的理解旨在定义和评估复发恐惧的组成部分，确定治疗靶点，并最终改善患者预后。
