[Anxiety-depressive disorders and paroxysmal atrial fibrillation: the psychosomatic aspects]

One hundred and forty-five patients with paroxysmal atrial fibrillation were examined to evaluate the effectiveness of the correction of physical state in the course of complex (somatotropic and psychotropic) therapy. Personality characteristics of patients with arrhythmias, the structure and severity of stress and anxiety-depressive disorders preceding the manifestation of paroxysmal atrial fibrillation were studied. Patients were examined at baseline and at the 21st day of therapy using clinical and instrumental methods (Holter ECG monitoring) and psychometric scales (the Beck Depression Inventory, the Zung Self-Rating Anxiety Scale, the Hamilton Depression Rating scale, the Hamilton Anxiety Rating scale). The complex treatment of patients with paroxysmal atrial fibrillation with SSRI antidepressants (paroxetine, fluvoxamine, sertraline) allowed to rapidly reduce neurotic anxiety depressive disorders. There was a significant positive trend in the course and frequency of paroxysms of atrial fibrillation on 21st day of treatment. These remedies help to reduce the duration of arrhythmia's attack which has already begun facilitating its relief. After 3-5 months of such regular complex pharmacotherapy, paroxysms of atrial fibrillation were completely stopped in 10.3% of patients. The follow-up investigation 18 months later showed that patients with certain personality traits and the positive dynamics of paroxysmal atrial fibrillation under a complex (somatotropic and psychotropic) treatment can develop cardiophobia' attacks in recurrent significant stress situations. Side-effects of the drugs were not significant and did not require discontinuation of the treatment.