Atrial Fibrillation Catheter Ablation and Psychological Distress

To the Editor A recent study examined the effects of atrial fibrillation catheter ablation on mental health. This is a clinically relevant area of research, and the results are certainly interesting, although there is a question, in our opinion, regarding the nature of the observed associations. Treatment for depression is notorious for placebo effects, and it appears such effects may be due to activation of certain neurotransmitting pathways by the “idea” of active treatment. Research has shown that placebo-induced activation of the μ-opioid system is implicated in the formation of placebo antidepressant effects, even when completely inactive pseudomedication is administered. We therefore wonder whether a sham ablation procedure would be needed to demonstrate a true “antidepressant” effect of ablation for atrial fibrillation. Additionally, we would like the authors to comment on the correlation between postablation atrial fibrillation burden and anxiety and depression, considering that arrhythmia burden was not quantified in a u niform manner in all study patients.
Source: JAMA - Category: General Medicine Source Type: research