1Ostalb-Klinikum Aalen Innere Medizin II, Kardiologie und Angiologie Aalen, Deutschland; 2University of Florence Department of Experimental and Clinical Medicine Firenze, Italien
Background: Depression and anxiety disorder frequently occur in patients with cardiac illnesses. Limited studies have investigated the prevalence and clinical features of these mental disorders in patients with atrial fibrillation (AF) undergoing Pulmonary Vein Isolation (PVI). The study aims to systematically review the existing literature and to calculate the pooled prevalence of depression and anxiety disorder as well as the prevalence of these before and after undergoing PVI.
Methods: A systematic literature search was conducted in the databases PubMed, Web of Science, PsycInfo, Trial, Embase, and Opengrey. A total of 2,432 studies were screened, among them 91 fulfilled eligibility criteria. Meta-analyses applying generalized linear mixed-effects models were performed in RStudio.
Results: The systematic review resulted in 20 studies which can be categorized into the following themes: 1.) Identification of depression and anxiety disorder pre- or post-ablation; 2.) Impact of PVI on depression or anxiety disorder; 3.) Consequences of anxiety disorder and depression on AF recurrence; 4.) Predictors for hospital admission, PVI procedures, and depression/anxiety disorders; 5.) Prevalence rates for depression and anxiety disorder. The meta-analysis revealed an overall pooled prevalence of 25.6% (CI[16.5;37.5], I² = 98.9; tau² = 0.894) for depression and an overall pooled prevalence of 23.6% (CI[12.6;39.9], I² = 98.8; tau² = 0.172) for anxiety disorder. Detailed subgroup analyses will also be presented at the congress.
Discussion: Existing literature on mental disorders in AF patients remains scarce, with few studies focusing on the immediate pre- or post-intervention periods. The high prevalence of depression and anxiety disorder emphasizes the need for psychological support for this population. The results of this study provide essential rationales for the adaptation of national and international guidelines to ensure a patient-tailored care path.