Depressed mood amplifies heart-related symptoms in persistent and paroxysmal atrial fibrillation patients: a longitudinal analysis—data from the German Competence Network on Atrial Fibrillation
Abstract
AIMS: There is limited evidence of an association between the burden of atrial fibrillation (AF)-related symptoms and depressed mood (DM). We used follow-up data from two randomized trials to relate AF symptoms, perceived AF burden, and DM. METHODS AND RESULTS: Baseline data on 319 persistent AF patients from the Flec-SL trial and 244 paroxysmal AF patients from the ANTIPAF trial were available. Data on 400 patients were available at 6-month follow-up. Depressed mood was measured using the major depression inventory, AF symptoms using the AF Symptom Checklist. Generalized estimating equation models were used to assess the association between symptom burden and DM. At baseline, 194 patients (35.2%) reported DM, 294 (52.2%) reported severe AF symptom burden. Burden from all symptoms except fainting was significantly elevated in patients with DM. An improvement in DM from baseline to follow-up was associated with reduced symptom burden [odds ratio (OR) = 2.06; 95% confidence interval (CI): 1.22-3.51]. Patients with DM had three-fold increased odds of severe symptom burden after adjustment for perceived AF-frequency and -duration, sex, and chronic obstructive pulmonary disorder (COPD) (OR = 3.19; 95% CI: 2.65-8.45). Women reported significantly more severe symptom burden than men (OR = 1.44; 95% CI: 1.36-1.95). Uneasiness, nausea, and shortness of breath were most strongly associated with DM. The effect of DM on nausea was more pronounced for men (P(interaction) = 0.041). Perceived AF-frequency and -duration were not associated with DM (P = 0.717 and 0.236, respectively). CONCLUSION: Depressed mood is associated with AF symptom burden over 6 months after adjustment for perceived frequency and duration of AF episodes, COPD, and sex.
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Anxiety and psychological stress are highly prevalent among people with AF, affecting 25% to 45% of patients, and are associated with greater symptom burden, higher rates of health care utilization, and worse quality of life.
“Anxiety and psychological stress are also highly prevalent among people with AF, affecting 25% to 45% of patients, 11 , 12 , 13 and are associated with greater symptom burden, higher rates of health care utilization, and worse quality of life.”
From Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation (2024) · cites this paper as [13]
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- Authors
- von Eisenhart Rothe, A., Hutt, F., Baumert, J., Breithardt, G., Goette, A., Kirchhof, P., & Ladwig, K.-H.
- Affiliations
- Helmholtz Munich (DE)
- University Hospital Münster (DE)
- University Hospital Magdeburg (DE)
- TUM Klinikum (DE)
- Corresponding author
- Ladwig, Karl-Heinz
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-03-29
- Volume
- 17
- Issue
- 9
- Pages
- 1354-1362
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2126186405
- Cited by
- 63
- References
- 20
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 10
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Site cant be reached (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Funders
- Kompetenznetz Vorhofflimmern
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- depressive mood, atrial fibrillation, symptom burden, persistent atrial fibrillation, paroxysmal atrial fibrillation, nausea, dyspnea, sex differences, chronic obstructive pulmonary disease
- MeSH terms
- Aged, Atrial Fibrillation, Depression, Female, Germany, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Multivariate Analysis, Randomized Controlled Trials as Topic, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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