Anxiety is associated with higher recurrence of atrial fibrillation after catheter ablation: A meta‐analysis

Du, Hongling; Yang, Lei; Hu, Zheng; Hui, Zhang

doi:10.1002/clc.23753

Cited by 13 publications

(5 citation statements)

References 43 publications

(80 reference statements)

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“…However, our study did not find a causal relationship between anxiety disorder and AF. Although previous studies generally suggest a positive association between anxiety and the risk of AF, 40 subsequent findings have yielded inconsistent results. A meta‐analysis of 11 cohort studies reported no significant association between psychological factors such as anxiety, depression, anger, work stress, and the risk of AF 41 .…”

Section: Discussionmentioning

confidence: 86%

Anxiety disorder and cardiovascular disease: a two‐sample Mendelian randomization study

Peng,

Meng,

Guo

et al. 2024

ESC Heart Failure

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AimsCardiovascular disease is the leading cause of death worldwide. Anxiety disorders are common psychiatric conditions associated with cardiovascular outcomes. This two‐sample Mendelian randomization (MR) study investigated the causal relationship between anxiety disorders and coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF), and atrial fibrillation (AF).MethodsSingle nucleotide polymorphisms (SNPs) associated with anxiety disorders (16 730 cases; 101 021 controls) were obtained from the UK Biobank genome‐wide association study (GWAS). Cardiovascular outcome data were derived from the FinnGen study (CHD: 21 012 cases and 197 780 controls; MI: 12 801 cases and 187 840 controls; HF: 23 397 cases and 194 811 controls; and AF: 22 068 cases and 116 926 controls). Inverse variance weighted (IVW), MR–Egger, weighted median, simple mode, and weighted mode analyses examined causality.ResultsIVW analysis demonstrated significant causal relationships between anxiety disorders and increased risk of CHD [odds ratio (OR): 4.496; 95% confidence interval (CI): 1.777–11.378; P = 0.002], MI (OR: 5.042; 95% CI: 1.451–17.518; P = 0.011), and HF (OR: 3.255; 95% CI: 1.461–7.252; P = 0.004). No relationship was observed with AF (OR: 1.775; 95% CI: 0.612–5.146; P = 0.29). Other methods showed non‐significant associations. Two‐way analysis indicated no reverse causality.ConclusionsAnxiety disorders were causally associated with greater risk of CHD, MI, and HF but not AF among individuals of European descent. Further research on mediating mechanisms and in diverse populations is warranted.

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Section: Discussionmentioning

confidence: 86%

Anxiety disorder and cardiovascular disease: a two‐sample Mendelian randomization study

Peng,

Meng,

Guo

et al. 2024

ESC Heart Failure

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“…However, AF recurrence after CA is not uncommon. Several factors are believed to be implicated, including structural heart disease, left atrium characteristics (diameter, voltage), PV isolation-reconnections, AF duration, the presence of non-PV triggers, cardiometabolic risk factors, chronic kidney disease, and anxiety [ 27 , 28 , 29 ]. Interestingly, AF ablation in the CABANA randomized clinical trial led to reductions in left atrial volume index and mean PV ostial diameter, which were associated with lower AF recurrence rates [ 30 ].…”

Section: Atrial Fibrillation Catheter Ablationmentioning

confidence: 99%

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Theofilis

Oikonomou²,

Antonopoulos³

et al. 2022

Biomedicines

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Atrial fibrillation (AF), the most common sustained arrhythmia in clinical practice, represents a major cause of morbidity and mortality, with an increasing prevalence. Pharmacologic treatment remains the cornerstone of its management through rhythm and rate control, as well as the prevention of thromboembolism with the use of oral anticoagulants. Recent progress in percutaneous interventional approaches have provided additional options in the therapeutic arsenal, however. The use of the different catheter ablation techniques can now lead to long arrhythmia-free intervals and significantly lower AF burden, thus reducing the rate of its complications. Particularly encouraging evidence is now available for patients with persistent AF or concomitant heart failure, situations in which catheter ablation could even be a first-line option. In the field of stroke prevention, targeting the left atrial appendage with percutaneous device implantation may reduce the risk of thromboembolism to lower rates than that predicted with conventional ischemic risk scores. Left atrial appendage occlusion through the approved Watchman or Amplatzer devices is a well-established, efficacious, and safe method, especially in high-ischemic and bleeding risk patients with contraindications for oral anticoagulation.

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“…found that depression was associated with a significantly increased risk and cumulative incidence of new-onset AF ( 14 ). A meta-analysis of cohort studies demonstrated that anxiety was independently associated with an increased risk of recurrence of AF after catheter ablation (adjusted relative risk, 2.3; 95%CI, 1.710-3.260; P < 0.001) ( 15 ). One study demonstrated that the level of anxiety before coronary artery bypass surgery is an important factor in the development of AF after surgery ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Borderline personality disorder and risk of atrial fibrillation: insights from a bidirectional Mendelian randomization study

Zhou,

Wang,

et al. 2024

Front. Psychiatry

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BackgroundAtrial fibrillation (AF) is one of the most common form of arrhythmia. Previous studies have shown a link between AF and mental illness. However, the causal relationship between mental illness and AF remains unclear. The purpose of this study was to investigate the bidirectional causal relationship between borderline personality disorder (BPD) and AF.MethodWe used the bidirectional Two-sample Mendelian randomization (TSMR) method to evaluate the causal relationship between BPD and AF. Instrumental variables associated with BPD were derived from a genome-wide association study involving 214,816 Europeans (2,637 cases and 212,179 controls). We then obtained atrial fibrillation data from the GWAS meta-analysis (60,620 cases and 970,216 controls). The TSMR analyses were performed in five methods, namely fixed-effect inverse-variance weighted (IVW) method、random-effect IVW method, MR Egger regression method, Weighted median method and Simple mode method. Several sensitivity analyses are used to test the robustness of positive results.ResultsThe fixed-effect inverse-variance weighted model [Odds ratio (OR), 1.033, 95% confidence interval (CI), 1.011-1.056, P = 0.0031], random-effect inverse-variance weighted model (OR, 1.033; 95%CI, 1.005-1.062; P = 0.0191) and Weighted median (OR, 1.034; 95%CI, 1.002-1.068; P = 0.0394) all showed that genetically predicted BPD was associated with an increased risk of AF. Sensitivity analysis using other MR Methods, including the MR-Egger intercept, MR-Presso method, and leave-one-out analyses, showed that the results were robust. In reverse MR analysis, there was no causal relationship of AF on BPD.ConclusionOur study provides a causal relationship between BPD and AF. This means that patients with BPD should be monitored for the occurrence of AF. Early screening and proper management of BPD may show anti-arrhythmic benefits.

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Anxiety is associated with higher recurrence of atrial fibrillation after catheter ablation: A meta‐analysis

Cited by 13 publications

References 43 publications

Anxiety disorder and cardiovascular disease: a two‐sample Mendelian randomization study

Anxiety disorder and cardiovascular disease: a two‐sample Mendelian randomization study

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Borderline personality disorder and risk of atrial fibrillation: insights from a bidirectional Mendelian randomization study

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