Depression and recurrence of atrial fibrillation after catheter ablation: a meta-analysis of cohort studies
Chuanjun Zhuo, Feng Ji, Xiaodong Lin, Deguo Jiang, Lina Wang, Hongjun Tian, Yong Xu, Sha Liu, Ce Chen
Abstract
: The influence of depression on the recurrence of atrial fibrillation (AF) after catheter ablation remains unclear. We performed a meta-analysis to evaluate the association between depression and AF recurrence after catheter ablation. : Cohort studies that evaluated depression at baseline and correlated depression with AF recurrence after catheter ablation were identified by searching the PubMed and Embase databases. Heterogeneity was determined using the Cochrane's Q test and calculating the I2 statistic. A random-effect model was applied to incorporate the potential influence of heterogeneity. : Our analysis included seven cohort studies with 1,070 AF patients who underwent catheter ablation by circumferential pulmonary vein isolation. No significant heterogeneity was detected among the included studies (p for Cochrane's Q test = 0.20, I2 = 29%). Pooled results showed that depression before procedure was independently associated with increased risk of AF recurrence after catheter ablation (adjusted relative risk [RR]: 2.24, 95% confidence interval [CI]: 1.75 - 2.88, p < 0.001). Sensitivity analyses, conducted by omitting one study at a time, retrieved similar results (RR: 2.06 - 2.53, p all < 0.05). Predefined subgroup analyses showed that the association between depression and AF recurrence after catheter ablation was consistent regardless of the study characteristics, including study location, study design, patient number, type of AF, follow-up duration, adjustment of left atrial dimension, and quality score. : This analysis included a limited number of studies and various instruments applied to measure depression. : Depression is an independent risk factor of AF recurrence after catheter ablation.