title: Predictors of non-pharmacological intervention in patients with paroxysmal atrial fibrillation: Value of neuroticism.
abstract: BACKGROUND
  Non-pharmacological intervention is gaining increasing popularity in the treatment of patients with paroxysmal atrial fibrillation. We sought to investigate which factors play a role in the choice for non-pharmacological intervention with a particular focus on neuroticism.
  
  
  METHODS
  The study group comprised 73 patients with paroxysmal atrial fibrillation (mean age 55+/-13 years, 50 males). On average, patients had a 3-year-history of one symptomatic paroxysm per week lasting 2 h. The degree of neuroticism was assessed using the short scale Eysenck Personality Questionnaire.
  
  
  RESULTS
  During a mean follow-up period of 7.0+/-0.6 years, 20 patients (27%) underwent a non-pharmacological intervention for atrial fibrillation including His bundle ablation (n = 1), maze operation (n = 4), DDDR-pacemaker (n = 10), pulmonary vein ablation (n = 5). Multivariate regression analysis showed that age < 55 years (odds ratio 5.3, 95% CI 1.1-24.5), frequency of paroxysms of atrial fibrillation > 1 per week (odds ratio 5.9, 95% CI 1.2-28.5) and total number of anti-arrhythmic drugs (class I and III) used > 2 (odds ratio 3.4, 95% CI 1.6-6.9) were predictive of non-pharmacological intervention (all p < 0.05). In contrast, the degree of neuroticism was similar in patients who underwent non-pharmacological intervention as opposed to patients who did not undergo non-pharmacological intervention (4.5+/-3.3 vs. 4.0+/-2.9, p = NS).
  
  
  CONCLUSIONS
  On the basis of this small study, neuroticism would not appear to play an important role in the decision to perform a non-pharmacological intervention. Instead, the data indicate that younger patients with pharmacologically refractory atrial fibrillation more often undergo non-pharmacological intervention.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. m.e.w.hemels@thorax.umcg.nl
authors.forename: Martin E W
authors.initials: ME
authors.lastname: Hemels
authors.forename: Maarten P
authors.initials: MP
authors.lastname: van den Berg
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: Eric L P
authors.initials: EL
authors.lastname: van Sonderen
authors.forename: Isabelle C
authors.initials: IC
authors.lastname: van Gelder
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000150:complications*