Heart rhythm · 2025
Early rhythm control and mental health-related hospitalizations in young and middle-aged patients with atrial fibrillation.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Lee So-Ryoung, Ahn Hyo-Jeong, Choi Eue-Keun, Kim Bong-Seong, Han Kyung-Do, Oh Seil, Lip Gregory Y H
Аннотация
BACKGROUND: Atrial fibrillation (AF) is strongly associated with mental health disorders, increasing susceptibility to both AF and conditions such as depression and anxiety.
OBJECTIVE: This study investigated whether early rhythm control (ERC) within 1 year of AF diagnosis reduces mental health-related health care utilization in young and middle-aged individuals with preexisting mental health conditions.
METHODS: Using data from the Korean National Health Insurance Service (2010-2020), we identified 166,797 patients with AF <65 years with a history of depression or anxiety. Patients were classified into an ERC group (rhythm control within 1 year of diagnosis) and a usual care group. The primary outcome was hospitalization with depression or anxiety as the principal diagnosis. Secondary outcomes included hospitalizations where depression or anxiety was among the top 5 diagnoses and psychiatric hospitalizations. Cox regression and propensity score matching were used to assess risks.
RESULTS: A median follow-up duration was of 5.3 years (interquartile range 2.9-9.3). After 1:1 propensity score matching, ERC was associated with a lower risk of primary outcome hospitalization (hazard ratio [HR] 0.795, 95% confidence interval [CI] 0.689-0.916, P = .001). ERC also reduced hospitalizations with depression or anxiety (HR 0.852, 95% CI 0.815-0.890, P < .001) and psychiatric hospitalizations (HR 0.621, 95% CI 0.566-0.681, P < .001). Benefits were consistent across subgroups, with a stronger effect in younger patients.
CONCLUSION: ERC in young and middle-aged patients with AF aged <65 years with preexisting mental health conditions was associated with a lower risk of mental health-related hospitalizations, highlighting the importance of timely rhythm control in this population.
OBJECTIVE: This study investigated whether early rhythm control (ERC) within 1 year of AF diagnosis reduces mental health-related health care utilization in young and middle-aged individuals with preexisting mental health conditions.
METHODS: Using data from the Korean National Health Insurance Service (2010-2020), we identified 166,797 patients with AF <65 years with a history of depression or anxiety. Patients were classified into an ERC group (rhythm control within 1 year of diagnosis) and a usual care group. The primary outcome was hospitalization with depression or anxiety as the principal diagnosis. Secondary outcomes included hospitalizations where depression or anxiety was among the top 5 diagnoses and psychiatric hospitalizations. Cox regression and propensity score matching were used to assess risks.
RESULTS: A median follow-up duration was of 5.3 years (interquartile range 2.9-9.3). After 1:1 propensity score matching, ERC was associated with a lower risk of primary outcome hospitalization (hazard ratio [HR] 0.795, 95% confidence interval [CI] 0.689-0.916, P = .001). ERC also reduced hospitalizations with depression or anxiety (HR 0.852, 95% CI 0.815-0.890, P < .001) and psychiatric hospitalizations (HR 0.621, 95% CI 0.566-0.681, P < .001). Benefits were consistent across subgroups, with a stronger effect in younger patients.
CONCLUSION: ERC in young and middle-aged patients with AF aged <65 years with preexisting mental health conditions was associated with a lower risk of mental health-related hospitalizations, highlighting the importance of timely rhythm control in this population.