Mindfulness-based cognitive therapy (MBCT) for treatment of symptoms of depression among patients with atrial fibrillation (AF)

The aim of MindAFib is to test feasibility and efficacy of a mindfulness-based cognitive therapy (MBCT) program for patients with atrial fibrillation (AF) with symptoms of depression.

Symptoms of depression and anxiety are common in AF (i.e.,38% and 28-38%, respectively), and quality of life (QoL) is reduced. A recent Danish study reported that depression increases the risk of AF, and furthermore, associations between depression, symptom burden and increased mortality have been shown in AF. Intriguingly, inflammation is a common mechanism implicated both in the molecular pathophysiology of depression increasing the risk of developing depression, and in the pathogenesis of AF, increasing the risk of developing AF and all-cause mortality among AF patients. Thus, scientific evidence, acquired through reductionist approaches and methods, now is in support also of a non-dualistic- and non-cartesian understanding of health in patients with AF.

MBCT has been shown to reduce the risk of depression and anxiety and levels of
inflammatory markers in various chronic conditions. MBCT is considered feasible to implement in routine clinical practice and may have significant positive effects on both mental and physical health, however, the role of MBCT for patients with AF and symptoms of depression is currently not established.

Methods: Through a Patient and Public Involvement (PPI) process to design and perform a feasibility study with MBCT for AP patients with focus on recruitment, participant experiences, satisfaction and completion, followed by a full-scale RCT.

The study will be the first to assess the effects of MBCT on mental and physical health in patients with AF.

Atrieflimren (AF) - også kaldt forkammerflimren - er den hyppigste hjerterytmeforstyrrelse, og rammer op til 2 % af den europæiske befolkning. Mere end hver tiende over 80 år har sygdommen. Patienter med AF har en betydelig lavere livskvalitet end raske, og sammen med den konstante uvished, frygt og manglende kontrol rammes mange af angst og depressive symptomer.

Mindfulness-baseret terapi har i en række videnskabelige undersøgelser vist sig at kunne forbedre livskvaliteten, reducere stress, angst og depressive symptomer samt reducere symptomerne ved en række kroniske sygdomme som f.eks. andre kredsløbssygdomme, KOL, gigt og cancer. Sundhedsstyrelsen anbefaler således denne form for terapi som et supplement og/eller alternativ til medicinsk
behandling af depression.

Det er dog endnu uvist om mindfulness-baseret terapi er effektiv i
behandlingen af symptomer hos patienter med atrieflimren, som er en af de hastigst voksende folkesygdomme i DK i disse år.