News from EHRA: depression screening in AF clinics recommended

Br J Cardiol 2013;20:92-93 Leave a comment
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First published online August 30th 2013

Dr James Rosengarten reports highlights from the European Heart Rhythm Association (EHRA) Europace 2013 meeting held recently in Athens, Greece.

Patients with paroxysmal AF rate their heath-related quality of life (HRQoL) lower than their physicians do, according to results from the ANTIPAF (Angiotensin II Antagonist in Paroxysmal Atrial Fibrillation) trial. The study found these patients show signs of depression, sleeping disorders and low levels of physical activity even in the absence of significant concomitant cardiac disease.

Researchers led by Professor Karl Ladwig (Helmholtz Centre, Munich, Germany) analysed data from patients enrolled in the ANTIPAF trial, which examined discordance between AF patients and their doctors. Between February 2004 and September 2008, 334 patients (41% female and 59% male) with paroxysmal AF, without significant concomitant heart disease, and their physicians from 43 participating centres were asked to rate the patients’ HRQoL.

Results show physicians rated their patients’ HRQoL higher than patients, both for the mental component score and physical component score. In the regression analyses, depression was significantly associated with discord in the mental component score and the physical component score. Furthermore, sleeping disorders were associated with discord in the mental component score and physical activity with discord in the physical component score.

“Electrophysiologists (EPs) generally decide whether to take a more or less aggressive treatment approach according to the patient’s disease burden. Here, not only physical symptoms need to be taken into consideration, but also the patient’s mental health and quality of life in general. If EPs don’t know that their patients are suffering from depression they may not be offering them optimum treatments,” said Professor Ladwig. “Good communication between physicians and patients is of paramount importance for adherence to medications and long term prognosis,” he added.

James Rosengarten
Wessex Electrophysiology Fellow and BJCA Deanery Representative