The Lead Episode 33: Atrial Fibrillation Catheter Ablation vs Medical Therapy and Psychological Distress

JAMA

Pdf Summary

A randomized clinical trial conducted in Australia compared the impact of atrial fibrillation (AF) catheter ablation to medical therapy alone on markers of psychological distress in patients with symptomatic AF. The study enrolled 100 participants who were randomized to receive either AF catheter ablation (n=52) or medical therapy (n=48). The primary outcome was the Hospital Anxiety and Depression Scale (HADS) score at 12 months.<br /><br />The results showed that AF catheter ablation was associated with greater improvements in markers of psychological distress compared to medical therapy. The combined HADS score was significantly lower in the ablation group compared to the medical group at 6 months and 12 months. Similarly, the prevalence of severe psychological distress was lower in the ablation group at 6 months and 12 months.<br /><br />In addition to the improvement in psychological distress, the study also found that AF catheter ablation resulted in a lower AF burden compared to medical therapy. Successful pulmonary vein isolation was achieved in all participants in the ablation group.<br /><br />The study concluded that AF catheter ablation is associated with improvement in psychological symptoms of anxiety and depression in patients with AF. These findings highlight the importance of considering mental health outcomes in the management of AF. Further research with a larger sample size and a sham group would provide more information on the specific mechanisms associated with the improvement in mental health outcomes.

Keywords

randomized clinical trial

atrial fibrillation

AF catheter ablation

medical therapy

psychological distress

Hospital Anxiety and Depression Scale

HADS score

improvement in psychological distress

AF burden

pulmonary vein isolation