Relationship between psychological factors and atrial fibrillation: A meta-analysis and systematic review

BACKGROUND: Although several studies have investigated the role of psychological factors in atrial fibrillation (AF), the results are still under debate. Therefore, we performed a meta-analysis to examine the relationship between psychological factors and the risk of incident AF. METHODS: We systematically searched the PubMed and EMBASE databases from inception to December 2019 to identify eligible studies. The hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled by using a random-effects model. RESULTS: A total of 11 cohort studies were included in this meta-analysis. There were 5, 2, 4, and 5 studies examining the association of anxiety, anger, depression, and psychological stress with AF, respectively. In the pooled analysis by a random-effects model, anxiety (HR = 1.10, 95%CI 0.97–1.24; P = .14), anger (HR = 1.08, 95%CI 0.95–1.23; P = .21), depression (HR = 1.15, 95%CI 0.98–1.35; P = .08), and work stress (HR = 1.14, 95%CI 0.98–1.34; P = .09) were not associated with the risk of AF. These results were not changed when we re-performed the analysis using a fixed-effects model. CONCLUSIONS: Based on current evidence, no associations were observed for anger, anxiety, and work stress with the risk of AF.