Evaluation of Changes in Mental Health Parameters Following Ablation in Patients Treated with Pulmonary Vein Isolation

Yıl 2025, Cilt: 16 Sayı: 3, 643 - 652, 30.09.2025

Bilgen Biçer Kanat , Selcuk Kanat

https://doi.org/10.18663/tjcl.1790049

Öz

Aim: Atrial fibrillation (AF) is frequently associated with anxiety, depression, and impaired sleep quality. Pulmonary vein isolation (PVI) is an established ablation therapy for AF, yet its effects on mental health parameters remain less well explored. This study aimed to evaluate changes in anxiety, depression, and sleep quality before and after PVI.
Material and Methods: In this cross-sectional study, 117 patients undergoing PVI for AF were evaluated using validated questionnaires before and after ablation. Mental health parameters included the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Pre- and post-procedure scores were compared to assess changes in psychological well-being. Percentage change (Δ) in scores was calculated as [(post–pre)/pre] × 100. Associations between Δ values and baseline demographic, clinical, laboratory, and echocardiographic parameters were examined.
Results: The mean BAI score significantly decreased from 18.2 ± 5.1 at baseline to 15.0 ± 4.5 post-ablation, corresponding to a 20% reduction (p < 0.001). Similarly, a 19% decrease in BDI score was observed (p < 0.01). A 17% improvement in PSQI score was seen (p < 0.05). Greater improvements were noted in patients without coronary artery disease, while those with arrhythmia recurrence showed less benefit. In addition, patients with reduced baseline ejection fraction and enlarged ventricular dimensions experienced more pronounced psychological recovery.
Conclusion: PVI not only restores sinus rhythm but also improves psychological well-being and sleep quality in AF patients. The magnitude of benefit is influenced by comorbidities, arrhythmia recurrence, and baseline cardiac function, with the most pronounced improvements observed in patients with impaired ventricular function and without CAD.

Anahtar Kelimeler

atrial fibrillation , pulmonary vein isolation , ablation , mental health , anxiety , depression , sleep quality

Pulmoner Ven İzolasyonu ile Tedavi Edilen Hastalarda Ablasyon Sonrası Ruh Sağlığı Parametrelerindeki Değişikliklerin Değerlendirilmesi

Öz

Amaç: Atrial fibrilasyon (AF), sıklıkla anksiyete, depresyon ve uyku bozuklukları ile ilişkilidir. Pulmoner ven izolasyonu (PVI), AF tedavisinde standart ablasyon yöntemlerinden biridir; ancak mental sağlık parametreleri üzerindeki etkileri yeterince araştırılmamıştır. Bu çalışmada ablasyon öncesi ve sonrası anksiyete, depresyon ve uyku kalitesindeki değişiklikler incelendi.
Yöntemler: Kesitsel tasarıma sahip bu çalışmada 117 AF nedeniyle PVI uygulanan hastalar, işlem öncesi ve sonrası validasyonlu ölçeklerle değerlendirildi. Mental sağlık parametreleri Beck Anksiyete Ölçeği (BAI), Beck Depresyon Ölçeği (BDI) ve Pittsburgh Uyku Kalitesi İndeksi (PSQI) ile ölçüldü. İşlem öncesi ve sonrası skorlar karşılaştırılarak psikolojik iyilik halindeki değişim belirlendi. Skorlardaki değişim yüzdesi Δ = [(sonra–önce)/önce] × 100 formülü ile hesaplandı. Δ değerleri ile demografik, klinik, laboratuvar ve ekokardiyografik parametreler arasındaki ilişkiler incelendi.
Bulgular: Ortalama BAI skoru, başlangıçtaki 18,2 ± 5,1'den ablasyon sonrası 15,0 ± 4,5'e önemli ölçüde düştü; bu da %20'lik bir azalmaya karşılık geliyor (p < 0,001). Benzer şekilde, BDI skoru %19'luk bir azalma gözlendi (p < 0,01). PSQI skorunda %17'lik bir iyileşme görüldü (p < 0,05). Koroner arter hastalığı olmayan hastalarda daha fazla iyileşme kaydedilirken, aritmi tekrarı olan hastalarda daha az fayda görüldü. Ayrıca, bazal ejeksiyon fraksiyonu azalmış ve ventrikül boyutları büyümüş hastalarda psikolojik iyileşme daha belirgindi.
Sonuç: PVI, AF hastalarında yalnızca ritim kontrolü sağlamaz, aynı zamanda ruh sağlığı ve uyku kalitesini de iyileştirir. İyileşme derecesi komorbiditeler, aritmi rekürrensi ve kardiyak fonksiyonla ilişkilidir; özellikle ventrikül fonksiyonu bozulmuş ve CAD olmayan hastalar en belirgin faydayı görmektedir.

Anahtar Kelimeler

atriyal fibrilasyon , pulmoner ven izolasyonu , ablasyon , mental sağlık , anksiyete , depresyon , uyku kalitesi

Kaynakça

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