Atrial fibrillation (A-fib) is a common condition characterized by an irregular heart rhythm.
According to the Centers for Disease Control and Prevention (CDC), about 2.7–6.1 million people in the United States have A-fib.
Studies show that about a third of people with this heart condition also have symptoms of depression and anxiety.
Starting from this evidence, researchers from Australia decided to look into how various treatments for A-fib might influence a person’s levels of psychological distress.
The results of the study — the senior author of which is Jonathan Kalman, of the Royal Melbourne Hospital — were published earlier this week in the Journal of the American Heart Association.
Which treatment improves mental health?
The researchers worked with a cohort of 78 participants who had received some form of treatment for A-fib. The team monitored the participants’ levels of depression and anxiety and evaluated and took into consideration their personality traits.
Of the total number of participants, 20 had received ablations, a type of procedure through which the heart tissue that produces the irregular heartbeat is removed or destroyed.
The remaining 58 participants chose to take drugs to regulate heart rate and prevent the formation of blood clots.
At the beginning of the study, 35 percent of the participants said that they lived with symptoms of severe anxiety and psychological distress. A further 20 percent reported suicidal ideation.
After a year from the beginning of the study, those who opted for an ablation tended to report lower levels of depression and anxiety compared with those who took drugs as therapy.
More of the people who had received ablations also reported no longer having suicidal thoughts. Specifically, the number of individuals with suicidal ideation fell from six to one among those participants.
Kalman believes that the new findings “[demonstrate] that effective treatment of atrial fibrillation markedly reduces psychological distress.”
“This psychological impact,” he adds, “is not well appreciated by many heart specialists and is important to take into consideration” — particularly when deciding on the most appropriate treatment for A-fib.
Psychological distress and chronic conditions
The participants’ personality types appeared to have a bearing on whether or not they experienced psychological distress and suicidal ideation.
Individuals who displayed a type D personality were more at risk of anxiety and depression. This personality type is characterized by a predisposition to stress, anger, and pessimism, which has also been tied to poorer outcomes when experiencing a heart condition.
Thirty-five of the total number of participants had type D personalities. Dr. Dimpi Patel, a researcher specializing in the mind-heart link — who is based at the New Hanover Regional Medical Center in Wilmington, NC — explains that the association between heart conditions and psychological distress is important, albeit understudied.
“Patients need to be aware,” notes Dr. Patel, “that physical ailments can and do have psychological manifestations, and both must be acknowledged and managed to ensure a good quality of life and perhaps even prevent worse outcomes.”
While the new research offers fresh evidence that heart and mind health are closely interlinked, Dr. Patel explains that this association is likely to occur in many more conditions than just A-fib.
“It is important to note that psychological distress, depression, anxiety and, at times, suicidal ideation are not exclusive to atrial fibrillation, but to many chronic diseases such as diabetes, chronic obstructive pulmonary disease, and congestive heart failure.”
Dr. Dimpi Patel
“Physicians have an obligation,” she adds, “to broaden their approach in managing any chronic illness to include emphasis on the psychological well-being of their patient. To me, it is simply practicing good and compassionate medicine.”
