Raileanu Gabriela, Jawid Norzad, Bohte Evelien, Hof Irene E, Khan Muchtiar, de Ruiter Gijsbert S, Verbeek Eva C, de Jong Jonas S S G, Mol Daniel
Department of Cardiology, OLVG, Amsterdam, The Netherlands.
Arkin Mental Health Care, Department of Emergency Psychiatry, OLVG, Oosterpark 9, 1091 AC, Amsterdam, the Netherlands.
J Interv Card Electrophysiol. 2024 Jun;67(4):797-805. doi: 10.1007/s10840-023-01679-6. Epub 2023 Oct 28.
One third of patients with atrial fibrillation (AF) suffer from high levels of anxiety and depression, which may significantly impair quality of life (QoL). The purpose of this study was to assess whether depressive and anxiety symptoms before ablation affect the QoL in patients with AF one year after cryoballoon ablation (CBA).
This single-center retrospective study investigated whether the AF patients with a high Hospital Anxiety and Depression Scale (HADS) score (≥ 8) had worse outcomes than patients with a low pre-ablation HADS score (< 8). The primary outcome was the difference in post-ablation QoL, and the secondary outcome included the difference in pre-ablative QoL, QoL improvement, and self-reported AF.
Two hundred ninety-five patients were stratified according to their HADS scores (total, depression, and anxiety). Patients with an elevated HADS total, depression, or anxiety score (≥ 8), had a significantly lower QoL before and 12 months after CBA than patients with a HADS score < 8 (p-value < 0.001 for all groups). All groups improved significantly in QoL after CBA ablation and to a similar extent. Sixty-three percent of the patients reported AF symptoms after the procedure, which was comparable between the cohorts of patients.
Patients with elevated HADS scores reported a lower QoL compared to participants with low HADS scores at baseline and 12 months after CBA. However, both groups improved in QoL after CBA, irrespective of their depressive and anxiety symptoms.
三分之一的心房颤动（AF）患者存在高度焦虑和抑郁，这可能会显著损害生活质量（QoL）。本研究的目的是评估冷冻球囊消融术（CBA）前的抑郁和焦虑症状是否会影响AF患者在术后一年的生活质量。
这项单中心回顾性研究调查了医院焦虑抑郁量表（HADS）评分高（≥8分）的AF患者是否比消融术前HADS评分低（<8分）的患者预后更差。主要结局是消融术后生活质量的差异，次要结局包括消融术前生活质量的差异、生活质量的改善情况以及自我报告的房颤情况。
根据HADS评分（总分、抑郁和焦虑）对295例患者进行分层。HADS总分、抑郁或焦虑评分升高（≥8分）的患者在CBA术前和术后12个月的生活质量显著低于HADS评分<8分的患者（所有组的p值均<0.001）。所有组在CBA消融术后生活质量均有显著改善，且改善程度相似。63%的患者在术后报告有房颤症状，各队列患者之间这一比例相当。
与基线时和CBA术后12个月时HADS评分低的参与者相比，HADS评分升高的患者报告的生活质量较低。然而，两组在CBA术后生活质量均有所改善，无论其抑郁和焦虑症状如何。
