Depression linked to increased risk of atrial fibrillation
Depressed people have an increased risk of atrial fibrillation, according to a study published in the European Journal of Preventive Cardiology. Filling a prescription for antidepressants, which was used in this study as an indicator of depression, was associated with a three-fold greater risk of atrial fibrillation. However, medication was not responsible for the high frequency of atrial fibrillation in depressed people.
It is common knowledge that there is a connection between the mind and the heart. For example, depression predicts the development of coronary artery disease and worsens its prognosis (Piepoli MF et al. Eur Heart J 2016;37:2315). Previous studies have also found associations between depression and both more severe symptoms and higher mortality in atrial fibrillation patients (Rahman F et al. Nat Rev Cardiol 2014;11:639). Antidepressants have been linked with some serious, but rare, heart rhythm disturbances, prompting the question of whether they might also raise the risk of atrial fibrillation. This study investigated whether depression is also linked with atrial fibrillation.
The study included all 785,254 Danish citizens initiating antidepressant treatment from 2000 to 2013 and a 1:5 random sample of the Danish population matched on sex and birth month. The risk of atrial fibrillation was assessed after starting treatment and in the month before, when it was assumed that patients were depressed but medically untreated.
Compared with the general population, patients taking antidepressants had a 3.18-fold higher risk of atrial fibrillation during the first month of treatment. The association gradually reduced thereafter, to 1.37-fold at 2–6 months, and 1.11-fold at 6–12 months. This decrease over time could suggest that treatment may alleviate this risk.
The risk of atrial fibrillation risk was even higher in the month before starting antidepressants (7.65-fold) suggesting that antidepressant medication itself is not associated with the development of atrial fibrillation.
This study highlights the need to care for mental health as it can be detrimental to heart health. However, patients who already have atrial fibrillation should not be concerned about taking antidepressant medication if required.
Fenger-Grøn M, Vestergaard M, Pedersen HS, et al. Depression, antidepressants, and the risk of non-valvular atrial fibrillation: A nationwide Danish matched cohort study. Eur J Prev Cardiol. 2018. DOI: 10.1177/2047487318811184.
READ MORE ARTICLES