Effect of mental health status on arrhythmia recurrence after catheter ablation of atrial fibrillation

Abstract Background Patients diagnosed with atrial fibrillation (AF) suffer more from anxiety and depression than the general population. This study sought to evaluate the association between mental health status and recurrence of atrial tachyarrhythmia (AT) after catheter ablation. Methods A total of 448 patients undergoing catheter ablation for AF were enrolled in this single-center prospective cohort study. Mental Health Inventory-5 (MHI-5) was used to assess the mental health status at the end of the blanking period post-ablation and lower scores indicated poorer mental health status. Patients with no early recurrence (ER) of AT during the blanking period were included for analyses. Multivariate logistic regression was used to examine the association between mental health status and risk of arrhythmia recurrence in the following 3 months. Results Among 335 patients without ER during the blanking period, 36 patients (10.7%) experienced AT recurrence in the 3 months following the mental health status evaluation. Recurrence rates were 35.7%, 13.5%, 10.6% and 4.6% in patients with a MHI-5 score of 0-52, 53-75, 76-85 and 86-100, respectively (overall p＝0.004). A significant association between low MHI-5 scores and AT recurrence was observed after multivariate adjustment [OR: 8.81 (1.93-40.22), p=0.005 for MHI-5 score of 0-52 and 3.61 (1.05-12.35), p=0.041 for MHI-5 score of 53-75, compared with a MHI-5 score of 86-100]. Conclusions A poorer mental health status is associated with AT recurrence after catheter ablation. Intervention studies are warranted to evaluate the efficacy of counseling and psychological support after ablation in improving success rates in these patients.