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Canadian Journal of Cardiology

Effect of Mental Health Status on Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation

  • Zhaoxu Jia
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Xin Du
    Correspondence
    Corresponding authors: Dr Xin Du or Dr Changsheng Ma, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Rd, Chaoyang District, Beijing 100029, China. Tel.: +86-13-370103558 (X. Du) or +86-13-901357404 (C. Ma); fax: +86-10-84005363.
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Shangxin Lu
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Xiaoyi Yang
    Affiliations
    Faculty of Economics and Management, East China Normal University, Shanghai, China
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  • Sanshuai Chang
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Jiapeng Liu
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Jingye Li
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Yingchun Zhou
    Affiliations
    Faculty of Economics and Management, East China Normal University, Shanghai, China
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  • Laurent Macle
    Affiliations
    Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Jianzeng Dong
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
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  • Changsheng Ma
    Correspondence
    Corresponding authors: Dr Xin Du or Dr Changsheng Ma, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Rd, Chaoyang District, Beijing 100029, China. Tel.: +86-13-370103558 (X. Du) or +86-13-901357404 (C. Ma); fax: +86-10-84005363.
    Affiliations
    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
    Search for articles by this author
Published:February 16, 2019DOI:https://doi.org/10.1016/j.cjca.2019.02.007

      Abstract

      Background

      Patients diagnosed with atrial fibrillation suffer more from anxiety and depression than the general population. This study sought to evaluate the association between mental health status and recurrence of atrial tachyarrhythmia (AT) after catheter ablation.

      Methods

      A total of 448 patients who underwent catheter ablation for atrial fibrillation were enrolled in this single-centre prospective cohort study. Mental Health Inventory-5 (MHI-5) was used to assess the mental health status at the end of the blanking period after ablation and lower scores indicated poorer mental health status. Patients with no early recurrence of AT during the blanking period were included for analyses. Multivariate logistic regression was used to examine the association between mental health status and risk of arrhythmia recurrence in the following 3 months.

      Results

      Among 335 patients without early recurrence during the blanking period, 36 patients (10.7%) experienced AT recurrence in the 3 months after the mental health status evaluation. Recurrence rates were 35.7%, 13.5%, 10.6%, and 4.6% in patients with an MHI-5 score of 0-52, 53-75, 76-85, and 86-100, respectively (overall P = 0.004). A significant association between low MHI-5 scores and AT recurrence was observed after multivariate adjustment (odds ratio: 8.81 [1.93-40.22], P = 0.005 for the MHI-5 score of 0-52 and 3.61 [1.05-12.35], P = 0.041 for the MHI-5 score of 53-75, compared with an MHI-5 score of 86-100).

      Conclusions

      A poorer mental health status is associated with AT recurrence after catheter ablation. Intervention studies are warranted to evaluate the efficacy of counselling and psychological support after ablation in improving success rates in these patients.

      Résumé

      Contexte

      Les patients ayant reçu un diagnostic de fibrillation auriculaire souffrent davantage d'anxiété et de dépression que la population générale. Cette étude avait pour objectif d'évaluer l'association entre l'état de santé mentale et la récidive de la tachyarythmie auriculaire (TA) après une ablation par cathéter.

      Méthodologie

      Au total, 448 patients ayant subi une ablation par cathéter pour traiter leur fibrillation auriculaire ont été recrutés dans cette étude de cohorte prospective unicentrique. Le questionnaire Mental Health Inventory-5 (MHI-5) a été utilisé pour évaluer l'état de santé mentale à la fin de la période de suppression suivant l'ablation; plus ce score est faible, moins l'état de santé mentale est satisfaisant. Des analyses ont été effectuées chez les patients n'ayant pas présenté de récidive précoce de TA durant la période de suppression. Une analyse de régression logistique multivariée a été effectuée pour évaluer l'association entre l'état de santé mentale et le risque de récidive de l'arythmie au cours des 3 mois suivants.

      Résultats

      Parmi les 335 patients n'ayant pas présenté une récidive précoce durant la période de suppression, 36 (10,7 %) ont eu une récidive de TA au cours des 3 mois suivant l'évaluation de leur état de santé mentale. Les taux de récidive étaient respectivement de 35,7 %, 13,5 %, 10,6 % et 4,6 % chez les patients ayant obtenu un score au MHI-5 de 0 à 52, de 53 à 75, de 76 à 85 et de 86 à 100 (p pour l'ensemble = 0,004). Une association significative entre un score peu élevé au MHI-5 et la récidive de la TA a été observée après ajustement multivarié (rapport de cotes : 8,81 [1,93-40,22], p = 0,005 pour un score au MHI-5 de 0 à 52 et 3,61 [1,05-12,35], p = 0,041 pour un score au MHI-5 de 53 à 75, comparativement à un score au MHI-5 de 86 à 100).

      Conclusions

      Un état de santé mentale moins satisfaisant est associé à une récidive de la TA après une ablation par cathéter. Il est nécessaire de réaliser des études interventionnelles pour évaluer l'efficacité avec laquelle le counseling et le soutien psychologique après l'ablation permettent d'augmenter les taux de succès chez ces patients.
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      Linked Article

      • Mental Health Status and Arrhythmia Recurrence in Patients With Atrial Fibrillation After Catheter Ablation
        Canadian Journal of CardiologyVol. 37Issue 3
        • Preview
          Jia et al. evaluated the association between mental health status and recurrence of arrhythmia in patients with atrial fibrillation (AF) after catheter ablation.1 Mental Health Inventory-5 (MHI-5) was used to assess mental health status, and multivariate logistic regression was used for the analysis. Adjusted odds ratio (95% confidence intervals [CIs]) of MHI-5 scores of 0 to 52 and of 53 to 75, compared with an MHI-5 score of 86 to 100, for recurrence was 8.81 (1.93 to 40.22) and 3.61 (1.05 to 12.35), respectively.
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