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Updated: Jun 10, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Cognitive Behavioral Therapy for Paroxysmal Atrial Fibrillation: Heart Rate Variability, Physical Activity, and

H Skúladóttir¹, J Särnholm², E Ólafsdóttir¹

¹Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

|October 14, 2024

Summary

Cognitive behavioral therapy for atrial fibrillation (AF-CBT) reduced insomnia but did not affect heart rate variability or physical activity. This suggests AF-CBT may work through psychological mechanisms beyond current interventions.

Keywords:

Patch-Holter anxiety insomnia steps symptomatic

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Published on: July 20, 2022

Area of Science:

Cardiology
Psychology
Behavioral Science

Background:

Cognitive behavioral therapy for symptom preoccupation in paroxysmal atrial fibrillation (AF-CBT) improved quality of life.
The physiological impact of AF-CBT requires further investigation.

Purpose of the Study:

To evaluate the effects of AF-CBT on heart rate variability (HRV).
To assess the impact of AF-CBT on physical activity levels.
To determine the influence of AF-CBT on sleep duration and quality.

Main Methods:

Randomized controlled trial comparing 10-week online AF-CBT to AF education in paroxysmal AF patients.
Utilized 5-day Patch-Holter monitoring with accelerometry for objective data on AF burden, HRV, physical activity, and sleep.
Employed International Physical Activity Questionnaire (IPAQ) and Insomnia Severity Index for subjective assessments.

Main Results:

No significant changes were observed in AF burden, HRV, physical activity, or sleep duration between groups.
A significant reduction in Insomnia Severity Index scores was noted in the AF-CBT group compared to controls (P=0.032).
Baseline average steps/day were 8040 ± 2600, and sleep duration was 8.0 ± 1.1 hours.

Conclusions:

AF-CBT effectively decreased insomnia severity in patients with paroxysmal AF.
The therapy did not demonstrate a significant impact on HRV or physical activity levels.
AF-CBT may exert its benefits through psychological and behavioral pathways not addressed by conventional medical or lifestyle interventions.