title: Association of quality of life, anxiety, and depression with left atrial ablation outcomes.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with significant impairment of quality of life (QoL). Anxiety and depression are common in AF patients and might predispose to AF. We sought to investigate associations of preablative QoL and stress parameters with AF ablation outcomes, as well as possible changes in QoL, anxiety, and depression parameters after ablation.
  
  
  METHODS
  A total of 57 consecutive patients with paroxysmal AF underwent pulmonary vein (PV) antral isolation. The Short-Form Life Survey-36 items (SF-36), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI) were assessed before and at 6 months after ablation.
  
  
  RESULTS
  After a mean follow-up of 8.0 ± 2.5 months, 41 patients (71.9%) remained free from arrhythmia. Baseline mental health summary QoL SF-36 score was significantly lower in patients with AF recurrence (53.2 ± 10.3 vs 69.7 ± 17.9; P = 0.001), while the physical health summary score did not differ significantly between patients with and without recurrence. Patients with recurrence had higher baseline STAI-trait (41.9 ± 1.5 vs 34.7 ± 4.9) and BDI (17.3 ± 9.7 vs 5.4 ± 3.0) scores (P < 0.001 for both). In multivariable analysis, SF-36 mental health summary, STAI-trait, and BDI scores remained significant predictors of recurrence after adjustment for age, gender, body mass index, diabetes, and hypertension. Mental and physical domain SF-36 summary scores were significantly improved 6 months after ablation (P = 0.001) and a significant reduction in symptoms of depression (P = 0.001) and anxiety (P = 0.001) was observed.
  
  
  CONCLUSIONS
  Baseline QoL, anxiety, and depression metrics were associated with AF recurrence following PV antral isolation. Furthermore, there was a significant improvement in QoL, anxiety, and depression after left atrial ablation.
authors.affiliation: Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Efremidis
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Letsas
authors.forename: Louiza
authors.initials: L
authors.lastname: Lioni
authors.forename: Georgios
authors.initials: G
authors.lastname: Giannopoulos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vlachos
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Dimopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karlis
authors.forename: Georgios
authors.initials: G
authors.lastname: Bouras
authors.forename: Antonios
authors.initials: A
authors.lastname: Sideris
authors.forename: Spyridon
authors.initials: S
authors.lastname: Deftereos
mesh_terms: D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D017115:Catheter Ablation / Q000523:psychology* / Q000706:statistics & numerical data; D015984:Causality; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: anxiety; atrial fibrillation; catheter ablation; depression; quality of life