Arrhythmias & electrophysiologySecondary analysis
Impact of anxiety and depression in patients with atrial fibrillation: Insights from 2 international prospective registries
- Post hoc analysis of 2 prospective registries
- Europe and the Asia-Pacific
Authors' conclusion
In patients with AF, anxiety/depression symptoms were associated with worse clinical outcomes, with a stronger association observed in those with moderate-to-severe symptoms. These findings highlight the need for greater awareness of psychological assessment within AF management.
Study context
- Population
- Patients with atrial fibrillation (AF), classified as asymptomatic or symptomatic for anxiety/depressionmean age 69 ± 12 years, 38% female
- Participants
- 12,614 patients
- Comparison
- patients with AF with and without anxiety/depression
- Symptomatic for anxiety/depressionn = 4,825
- Primary endpoint
- Composite of:
- All-cause death
- Major adverse cardiovascular events (MACEs)
- Follow-up
- Median 569 days (interquartile range, 365-735 days)
Primary result
As reported in the abstract
Hazard ratio
1.26
95% CI 1.10–1.45
Symptomatic for anxiety/depression vs Asymptomatic for anxiety/depression
HR 1.26 (95% CI 1.10–1.45)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death · higher risk in symptomatic patients | 1.31 (1.12–1.55) | |
| MACE · higher risk in symptomatic patients | 1.44 (1.19–1.74) | |
| Cardiovascular death · higher risk in symptomatic patients | 1.87 (1.41–2.47) | |
| 0.512Hazard ratio (log scale) |
Baseline characteristics
- Symptomatic patients with anxiety/depression were more often female, were European, and had a higher prevalence of AF-related symptoms and heart failure
Sensitivity analyses by symptom severity and subgroups
- Risk increased with symptom severity
- no significant interaction was observed by geographic region or other analyzed subgroups
Original publication
Impact of anxiety and depression in patients with atrial fibrillation: Insights from 2 international prospective registries. Heart Rhythm. Published 4 June 2026. doi:10.1016/j.hrthm.2026.06.001
Summarised from the published abstract; every number is checked against it