Exploring Depressive Symptoms and Anxiety Among Patients With Atrial Fibrillation and/or Flutter at the Time of Cardioversion or Ablation.

Most participants were White males, so findings may not apply well to women or racial and ethnic minority patients with AF. The study was done at one cardiac electrophysiology clinic, which limits how broadly the results can be applied. The sample was small, and only a few participants had clinically significant depression or anxiety, so the researchers could not stratify groups well. This was an exploratory analysis, and some findings were discussed at a relaxed significance threshold, so chance findings are possible. Depression and anxiety were measured at one time point, and there was no pre-procedure data, so the study cannot show whether symptoms changed after cardioversion or ablation. Immediate relief from AF after cardioversion may have influenced some responses. The study shows associations, not causes, and it did not test whether screening or treating these symptoms improves AF recurrence or quality of life. Recurrence may have been under-recorded in participants with more depressive symptoms if they used monitoring less, attended visits less, or reported symptoms less.

The authors reported no relevant conflicts of interest. The article is listed as supported by NIH extramural research.

Do not conclude that treating anxiety or depression will reduce AF recurrence. Anxiety was not associated with recurrence, and the unexpected depression finding was exploratory, contradicted prior literature, and may reflect recurrence documentation bias.