Depression and Risk of Sudden Cardiac Death and Arrhythmias: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Psychiatry
• Epidemiology

Background:

• Depression is a global mental health issue often linked to physical symptoms.
• Existing research suggests a connection between depression and cardiac electrical instability, including sudden cardiac death (SCD) and arrhythmias.
• This review systematically examines the relationship between depression and the risks of SCD, atrial fibrillation (AF), and ventricular arrhythmias.

Purpose of the Study:

• To systematically evaluate the association between depression and the risk of sudden cardiac death (SCD).
• To assess the correlation between depression and the incidence of atrial fibrillation (AF).
• To investigate the link between depression and the occurrence of ventricular arrhythmias (VT/VF).

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Comprehensive literature search across PubMed, Embase, Web of Science, and Chinese databases up to April 10, 2025.
• Inclusion of cohort studies, with statistical analysis using random effects models and software like Review Manager 5.4 and STATA 16.0.

Main Results:

• Twenty studies were included, revealing a significant association between depression and increased risk of SCD (HR: 2.52).
• Depression was also significantly correlated with ventricular tachycardia/ventricular fibrillation (VT/VF) (HR: 1.38).
• Depression was linked to higher rates of AF recurrence (HR: 1.89) compared to new-onset AF (HR: 1.10).

Conclusions:

• This meta-analysis confirms a significant association between depression and elevated risks of SCD and arrhythmias (AF, VT/VF).
• Findings emphasize the critical need to integrate mental health assessments into cardiovascular risk management strategies.
• Proactive management of depression may be essential for reducing cardiac event risks.