The Psychological and Pharmacological Correlations of Atrial Fibrillation

Abstract

Atrial fibrillation (AF) is an arrhythmia characterized by disorganized electrical activity of the atria, secondary to ectopic focal discharge, leading to ineffective contraction and rapid heart rate. AF is the most common cardiac arrhythmia and is seen in approximately 1% to 2% of the population. Risk factors connected with AF include age, male gender, hypertension, valve disease, obesity, heart failure, diabetes, sleep apnea, cardiac surgery, smoking, alcohol consumption, and psychosocial stress. AF is associated with increased morbidity and mortality primarily due to coronary heart disease, heart failure, and stroke and has been associated with cognitive impairment and psychological distress. Treatment of AF should be focused on mitigating stroke risk as well as rate or rhythm control. AF is linked with depression, anxiety, and mood disorders as well as poor quality of life, but evidence suggests that these features can be improved with appropriate management. Further investigation is needed to inform and guide clinicians in therapeutic options and nonpharmacologic interventions for both the physical and psychiatric ramifications of AF. [ Psychiatr Ann . 2016;46(12):702–711.]