Aiginiteio University Hospital, Athens, Greece.
Patras University School of Medicine, Patras, Greece.
Int J Psychiatry Clin Pract. 2023 Nov;27(4):397-415. doi: 10.1080/13651501.2023.2248214. Epub 2023 Aug 24.
To explore the reciprocal relationship of depression and atrial fibrillation (AF).
A literature search was conducted in Pub Med, Scopus, and Google Scholar using relevant terms for depression and AF and respective therapies.
There is evidence that depression is involved in the aetiology and prognosis of AF. AF, independently of its type, incurs a risk of depression in 20-40% of patients. Also, depression significantly increases cumulative incidence of AF (from 1.92% to 4.44% at 10 years); 25% increased risk of new-onset AF is reported in patients with depression, reaching 32% in recurrent depression. Hence, emphasis is put on the importance of assessing depression in the evaluation of AF and vice versa. Persistent vs paroxysmal AF patients may suffer from more severe depression. Furthermore, depression can impact the effectiveness of AF treatments, including pharmacotherapy, anticoagulation, cardioversion and catheter ablation.
A reciprocal association of depression and AF, a neurocardiac link, has been suggested. Thus, strategies which can reduce depression may improve AF patients' course and treatment outcomes. Also, AF has a significant impact on risk of depression and quality of life. Hence, effective antiarrhythmic therapies may alleviate patients' depressive symptoms. KEY POINTSAF, independently of its type of paroxysmal, permanent or chronic, appears to have mental besides physical consequences, including depression and anxietyA reciprocal influence or bidirectional association of depression and AF, a neurocardiac link, has been suggestedAF has considerable impact on the risk of depression occurrence with 20-40% of patients with AF found to have high levels of depressionAlso, depression significantly increases 10-year cumulative incidence and risk of AF from 1.92% to 4.44% in people without depression, and the risk of new-onset AF by 25-32%Emphasis should be placed on the importance of assessing depression in the evaluation of AF and vice versaPersistent/chronic AF patients may suffer from more severe depressed mood than paroxysmal AF patients with similar symptom burdenDepression and anxiety can impact the effectiveness of certain AF treatments, including pharmacotherapy, anticoagulation treatment, cardioversion and catheter ablationThus, strategies which can reduce anxiety and depression may improve AF patients' course and treatment outcomesAlso, effective antiarrhythmic therapies to control AF may alleviate patients' depressive mood.
探讨抑郁与心房颤动（AF）之间的相互关系。
在 Pub Med、Scopus 和 Google Scholar 中使用抑郁和 AF 及其各自治疗方法的相关术语进行文献检索。
有证据表明，抑郁与 AF 的病因和预后有关。无论其类型如何，AF 都会使 20-40%的患者发生抑郁的风险。此外，抑郁显著增加 AF 的累计发生率（10 年内从 1.92%增加到 4.44%）；抑郁患者新发 AF 的风险增加 25%，复发性抑郁患者增加 32%。因此，强调在评估 AF 时评估抑郁的重要性以及反过来评估抑郁的重要性。持续性与阵发性 AF 患者可能患有更严重的抑郁。此外，抑郁会影响 AF 治疗的效果，包括药物治疗、抗凝治疗、电复律和导管消融。
已经提出抑郁和 AF 之间存在一种相互关联的关系，即神经心脏联系。因此，减少抑郁的策略可能会改善 AF 患者的病程和治疗结果。此外，AF 对抑郁风险和生活质量有重大影响。因此，有效的抗心律失常治疗可能会减轻患者的抑郁症状。
AF 似乎除了身体上的后果外，还有精神上的后果，包括抑郁和焦虑，无论其类型是阵发性、永久性还是慢性。
已经提出抑郁和 AF 之间存在相互影响或双向关联，即神经心脏联系。
AF 对抑郁发生的风险有很大影响，20-40%的 AF 患者有高水平的抑郁。
此外，在没有抑郁的人群中，抑郁显著增加 10 年的累计发病率和 AF 风险从 1.92%增加到 4.44%，新发 AF 的风险增加 25-32%。
因此，在评估 AF 时，应强调评估抑郁的重要性，反之亦然。持续性/慢性 AF 患者可能比症状负担相似的阵发性 AF 患者遭受更严重的抑郁情绪。
抑郁和焦虑会影响某些 AF 治疗方法的效果，包括药物治疗、抗凝治疗、电复律和导管消融。
因此，能够减轻焦虑和抑郁的策略可能会改善 AF 患者的病程和治疗结果。
此外，有效的抗心律失常疗法来控制 AF 可能会减轻患者的抑郁情绪。
