PO-02-194 CHANGES IN ANXIETY AND DEPRESSION IN ATRIAL FIBRILLATION PATIENTS AFTER RECEIVING MULTIDISCIPLINARY CARE AT AN ATRIAL FIBRILLATION CENTER OF EXCELLENCE

Abstract

Anxiety and depression are known to occur in over one third of patients with atrial fibrillation (AF) and may negatively affect quality of life (QoL) and AF symptom severity. Though highly prevalent, the relationship between anxiety and depression with AF care remains poorly defined. The goal of an Atrial Fibrillation Center of Excellence (AFCoE) is to improve outcomes by delivering team-based multidisciplinary care to streamline risk factor modification while incorporating performance -measures and ongoing quality improvement to facilitate data-driven delivery of high-quality, guideline directed care. In the pilot phase of the AFCoE at the Inova Heart and Vascular Institute, an AF care coordinator and specialists from electrophysiology and sleep medicine were included based on patient need. To investigate changes in mental health status following multidisciplinary AF care received in an AFCoE in patients with AF. 138 patients were referred to the Inova AFCoE pilot between 10/2021 and 4/2022. Demographic and clinical comorbidities were ascertained. The frequency and severity of anxiety and depression were measured in a subset of participants (n=41) using the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) tools administered at baseline and again between 3 to 6 months after their initial AFCoE visit. Baseline and follow-up summed GAD-7 and PHQ-9 scores were compared using the Wilcoxon test. Additional analyses were performed among patients with clinically significant baseline anxiety (GAD-7 score ≥5 points) or depression (PHQ-9 score ≥5 points). A total of 12/41 (29%) patients had clinically significant depression or anxiety (scores ≥5 points) at baseline. Among patients with clinically significant depression or anxiety at baseline, the median [interquartile range] summed score improved at follow-up from 13[11–15] to 6[1–9] points (p=0.005, score reduction 8[2–14] points). Nearly one third of patients referred to the Inova AFCoE pilot phase had clinically significant anxiety and/or depression at baseline. Multidisciplinary AF treatment without specific behavioral health intervention was associated with clinically significant improvements in anxiety and depression.