Chuanjun Zhuo1, Feng Ji2, Xiaodong Lin3, Deguo Jiang3, Lina Wang4, Hongjun Tian4, Yong Xu5, Sha Liu5, Ce Chen3. 1. Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272100, Shandong Province, China; Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China; Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab) Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin,300222, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China. Electronic address: chuanjunzhuotjmh@163.com. 2. Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272100, Shandong Province, China. 3. Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China. 4. Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab) Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin,300222, China. 5. Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
Abstract
BACKGROUND: The influence of depression on the recurrence of atrial fibrillation (AF) after catheter ablation remains unclear. We performed a meta-analysis to evaluate the association between depression and AF recurrence after catheter ablation. METHODS: Cohort studies that evaluated depression at baseline and correlated depression with AF recurrence after catheter ablation were identified by searching the PubMed and Embase databases. Heterogeneity was determined using the Cochrane's Q test and calculating the I2 statistic. A random-effect model was applied to incorporate the potential influence of heterogeneity. RESULTS: Our analysis included seven cohort studies with 1,070 AF patients who underwent catheter ablation by circumferential pulmonary vein isolation. No significant heterogeneity was detected among the included studies (p for Cochrane's Q test = 0.20, I2 = 29%). Pooled results showed that depression before procedure was independently associated with increased risk of AF recurrence after catheter ablation (adjusted relative risk [RR]: 2.24, 95% confidence interval [CI]: 1.75 - 2.88, p < 0.001). Sensitivity analyses, conducted by omitting one study at a time, retrieved similar results (RR: 2.06 - 2.53, p all < 0.05). Predefined subgroup analyses showed that the association between depression and AF recurrence after catheter ablation was consistent regardless of the study characteristics, including study location, study design, patient number, type of AF, follow-up duration, adjustment of left atrial dimension, and quality score. LIMITATIONS: This analysis included a limited number of studies and various instruments applied to measure depression. CONCLUSIONS: Depression is an independent risk factor of AF recurrence after catheter ablation.
BACKGROUND: The influence of depression on the recurrence of atrial fibrillation (AF) after catheter ablation remains unclear. We performed a meta-analysis to evaluate the association between depression and AF recurrence after catheter ablation. METHODS: Cohort studies that evaluated depression at baseline and correlated depression with AF recurrence after catheter ablation were identified by searching the PubMed and Embase databases. Heterogeneity was determined using the Cochrane's Q test and calculating the I2 statistic. A random-effect model was applied to incorporate the potential influence of heterogeneity. RESULTS: Our analysis included seven cohort studies with 1,070 AFpatients who underwent catheter ablation by circumferential pulmonary vein isolation. No significant heterogeneity was detected among the included studies (p for Cochrane's Q test = 0.20, I2 = 29%). Pooled results showed that depression before procedure was independently associated with increased risk of AF recurrence after catheter ablation (adjusted relative risk [RR]: 2.24, 95% confidence interval [CI]: 1.75 - 2.88, p < 0.001). Sensitivity analyses, conducted by omitting one study at a time, retrieved similar results (RR: 2.06 - 2.53, p all < 0.05). Predefined subgroup analyses showed that the association between depression and AF recurrence after catheter ablation was consistent regardless of the study characteristics, including study location, study design, patient number, type of AF, follow-up duration, adjustment of left atrial dimension, and quality score. LIMITATIONS: This analysis included a limited number of studies and various instruments applied to measure depression. CONCLUSIONS:Depression is an independent risk factor of AF recurrence after catheter ablation.
Authors: Valérie Pavlicek; Sonja Maria Wedegärtner; Dominic Millenaar; Jan Wintrich; Michael Böhm; Ingrid Kindermann; Christian Ukena Journal: J Clin Med Date: 2022-03-22 Impact factor: 4.241