Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices
Abstract Objective Depression and anxiety show a bidirectional relationship with atrial fibrillation (AF). Antidepressant use is associated with a reduction in the incidence of AF. However, no studies have examined the relationship between antidepressant use and AF burden (time in AF). This retrospe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12948 |
| _version_ | 1827615284782956544 |
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| author | Youlin Koh Cecilia Kwok Aleksandr Voskoboinik Jonathan M. Kalman Michael Wong |
| author_facet | Youlin Koh Cecilia Kwok Aleksandr Voskoboinik Jonathan M. Kalman Michael Wong |
| author_sort | Youlin Koh |
| collection | DOAJ |
| description | Abstract Objective Depression and anxiety show a bidirectional relationship with atrial fibrillation (AF). Antidepressant use is associated with a reduction in the incidence of AF. However, no studies have examined the relationship between antidepressant use and AF burden (time in AF). This retrospective cohort study examined cardiac implantable device‐detected AF episodes and their relationship with antidepressant use, among other treatment factors. Methods Consecutive patients from the Western Health Cardiology Department attending pacemaker checks between 2015 and 2021 were included. Patients with permanent AF were excluded, yielding 285 patients with no or paroxysmal AF, with a total of 772 patient encounters. Generalized estimating equations were used to model two processes: binary AF (present/absent) and the number of days in AF for patients with AF. Results Each yearly increase with age was associated with an increase in the odds of developing AF (OR 1.03 [1.00–1.05], p = .027). Male gender conferred a reduction in AF incidence (OR 0.30 [0.13–0.68], p = .004). Digoxin use was associated with incident AF (OR 4.43 [1.07–18.4], p = .04). Sotalol and heart‐failure beta blocker use were associated with a decrease in AF burden (IRR 0.30 [0.12–0.78], p = .013 and 0.33 [0.14–0.81], p = .015). Selective serotonin reuptake inhibitor antidepressant use was associated with reduced AF burden (IRR 0.27 [0.09–0.81], p = .019), as was selective serotonin/noradrenaline reuptake inhibitor use (IRR 0.07 [0.03–0.15], p < .001). Conclusions Older age, female gender and digoxin are associated with a higher odds of developing incident AF. Sotalol, heart failure beta blockers and serotonin‐based antidepressants are associated with reduced AF burden. Further prospective study into the effects of antidepressants on atrial arrhythmias is warranted. |
| first_indexed | 2024-03-09T09:07:52Z |
| format | Article |
| id | doaj.art-36df84fdf12b432096d12dfed85ef203 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-09T09:07:52Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-36df84fdf12b432096d12dfed85ef2032023-12-02T09:34:11ZengWileyJournal of Arrhythmia1880-42761883-21482023-12-0139687688310.1002/joa3.12948Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devicesYoulin Koh0Cecilia Kwok1Aleksandr Voskoboinik2Jonathan M. Kalman3Michael Wong4Department of Cardiology Western Health St Albans Victoria AustraliaDepartment of Cardiology Western Health St Albans Victoria AustraliaDepartment of Cardiology Western Health St Albans Victoria AustraliaDepartment of Cardiology Royal Melbourne Hospital Melbourne Victoria AustraliaDepartment of Cardiology Western Health St Albans Victoria AustraliaAbstract Objective Depression and anxiety show a bidirectional relationship with atrial fibrillation (AF). Antidepressant use is associated with a reduction in the incidence of AF. However, no studies have examined the relationship between antidepressant use and AF burden (time in AF). This retrospective cohort study examined cardiac implantable device‐detected AF episodes and their relationship with antidepressant use, among other treatment factors. Methods Consecutive patients from the Western Health Cardiology Department attending pacemaker checks between 2015 and 2021 were included. Patients with permanent AF were excluded, yielding 285 patients with no or paroxysmal AF, with a total of 772 patient encounters. Generalized estimating equations were used to model two processes: binary AF (present/absent) and the number of days in AF for patients with AF. Results Each yearly increase with age was associated with an increase in the odds of developing AF (OR 1.03 [1.00–1.05], p = .027). Male gender conferred a reduction in AF incidence (OR 0.30 [0.13–0.68], p = .004). Digoxin use was associated with incident AF (OR 4.43 [1.07–18.4], p = .04). Sotalol and heart‐failure beta blocker use were associated with a decrease in AF burden (IRR 0.30 [0.12–0.78], p = .013 and 0.33 [0.14–0.81], p = .015). Selective serotonin reuptake inhibitor antidepressant use was associated with reduced AF burden (IRR 0.27 [0.09–0.81], p = .019), as was selective serotonin/noradrenaline reuptake inhibitor use (IRR 0.07 [0.03–0.15], p < .001). Conclusions Older age, female gender and digoxin are associated with a higher odds of developing incident AF. Sotalol, heart failure beta blockers and serotonin‐based antidepressants are associated with reduced AF burden. Further prospective study into the effects of antidepressants on atrial arrhythmias is warranted.https://doi.org/10.1002/joa3.12948antidepressantatrial fibrillationcardiac implantable electronic devicespacemakerselective serotonin reuptake inhibitors |
| spellingShingle | Youlin Koh Cecilia Kwok Aleksandr Voskoboinik Jonathan M. Kalman Michael Wong Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices Journal of Arrhythmia antidepressant atrial fibrillation cardiac implantable electronic devices pacemaker selective serotonin reuptake inhibitors |
| title | Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| title_full | Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| title_fullStr | Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| title_full_unstemmed | Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| title_short | Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| title_sort | serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices |
| topic | antidepressant atrial fibrillation cardiac implantable electronic devices pacemaker selective serotonin reuptake inhibitors |
| url | https://doi.org/10.1002/joa3.12948 |
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