Association between catheter ablation and psychiatric disorder risk in adults with atrial fibrillation: a multi-institutional retrospective cohort study.

IF 3.2 3区 医学 Q2 PSYCHIATRY Frontiers in Psychiatry Pub Date : 2025-03-21 eCollection Date: 2025-01-01 DOI:10.3389/fpsyt.2025.1467876
Ting-Hui Liu, Jheng-Yan Wu, Po-Yu Huang, Wan-Hsuan Hsu, Min-Hsiang Chuang, Ya-Wen Tsai, Kuang-Yang Hsieh, Chih-Cheng Lai
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Abstract

Background: Given that atrial fibrillation (AF) s associated with a high risk of psychiatric disorders, understanding the potential benefits of catheter ablation is clinically significant. This study was conducted to examine whether catheter ablation can prevent psychiatric disorders in patients with AF.

Methods: A retrospective cohort study was conducted over two years using data from the TriNetX electronic health record network. The study included adults diagnosed with AF and treated with either antiarrhythmic or rate-control medications. Participants were divided into two groups: those who underwent catheter ablation and a control group without ablation. The primary outcome measured was a composite of anxiety, depression, and insomnia occurrence within one to three years post-treatment. Secondary outcomes included individual psychiatric disorders, suicidal ideation or attempts, dementia, cerebral infarction, and atopic dermatitis (as a negative control).

Results: We included 21,019 patients in each matched group. The ablation group demonstrated a lower risk of the primary combined outcome (hazard ratio(HR):0.873, 95% confidence interval (CI) 0.784-0.973, p<0.01), and secondary outcomes including anxiety (HR:0.822, 95% CI:0.700-0.964; p=0.016), depression (HR:0.614, 95% CI:0.508-0.743; p<0.001), suicidal ideation or attempts (HR:0.392, 95% CI:0.165-0.934; p=0.028), dementia (HR:0.569, 95% CI:0.422-0.767; p<0.001), and cerebral infarction (HR:0.704, 95% CI:0.622-0.797; p<0.001) compared to the non-ablation group.

Conclusions: In patients with atrial fibrillation, catheter ablation was associated with a reduced risk of developing psychiatric disorders, including anxiety, depression, insomnia, suicidal ideation or attempt, and dementia, in comparison to those who did not undergo ablation. Clinicians should consider incorporating psychiatric risk factors into their comprehensive patient assessment when evaluating candidates for catheter ablation.

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房颤患者导管消融与精神障碍风险的关系:一项多机构回顾性队列研究
背景:鉴于心房颤动(AF)与精神疾病的高风险相关,了解导管消融的潜在益处具有临床意义。本研究旨在探讨导管消融是否可以预防房颤患者的精神障碍。方法:采用TriNetX电子健康记录网络的数据进行了为期两年的回顾性队列研究。该研究包括被诊断为房颤并接受抗心律失常或速率控制药物治疗的成年人。参与者被分为两组:接受导管消融术的组和未接受消融术的对照组。测量的主要结果是治疗后一到三年内焦虑、抑郁和失眠的综合情况。次要结局包括个体精神障碍、自杀意念或企图、痴呆、脑梗死和特应性皮炎(作为阴性对照)。结果:我们在每个匹配组中纳入了21,019例患者。消融组主要综合结局的风险较低(风险比(HR):0.873, 95%可信区间(CI) 0.784-0.973)。结论:在房颤患者中,与未接受消融的患者相比,导管消融与发生精神疾病的风险降低相关,包括焦虑、抑郁、失眠、自杀意念或企图以及痴呆。临床医生在评估导管消融候选者时应考虑将精神危险因素纳入其综合患者评估。
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来源期刊
Frontiers in Psychiatry
Frontiers in Psychiatry Medicine-Psychiatry and Mental Health
CiteScore
6.20
自引率
8.50%
发文量
2813
审稿时长
14 weeks
期刊介绍: Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.
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