Abstract 4148046: A Comparison of Anxiety and Depression in Patients with Symptoms of Palpitations Compared to High Risk Arrythmia Patients.

Background: Palpitations are the second most common presenting symptom for cardiology visits. The prevalence of anxiety and depressive disorders in patients with symptoms of arrhythmia, palpitations, is well documented but how this compares to patients at the greatest risk for major cardiac arrythmia is unknown. Objectives: The purpose of this study was to determine the prevalence of anxiety or depression in patients with symptomatic palpitations vs patients at risk for major cardiac arrhythmia (congestive heart failure) and further evaluate the effects on their quality of life using the SF-36 assessment tool. Methods: Patients with palpitations (50 subjects) or prior ICD (50 subjects) were given the General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) and the Short Form Health Survey (SF-36). Results: There was an insignificant trend for increased anxiety, with a mean GAD-7 score in palpitations group of 4.14 vs 3.04 in CHF group with anxiety prevalence in 40% palpitations and 28% of ICD patients. The mean score of PHQ-9 in palpitations group is 4.84 vs 4.96 in CHF group with 38% of the palpitation group having depression compared to 44% of the ICD group. The SF-36 physical function domain showed that the palpitations group was more functional than the ICD group with a mean score of 0.709 in palpitations group vs 0.513 in CHF group (P <0.05.) Subjective frequency of palpitations had a mean of 3.47 in the palpitation group vs 1.5 in the CHF group with P<0.05. Conclusions: Patients presenting with symptomatic palpitations have more symptoms of anxiety than patients at risk for major arrythmia, but have less functional limitations than the ICD group, as expected. There is a non-significant trend to more anxiety in the palpitations group, but both groups are far above populations norms of 2-4%. Depression is not different between the groups but both groups are far above the population averages of 5-6%. Patients with palpitations have fewer physical limitations but have at least an equal amount of anxiety and depression as a far more ill group of patients. It is a standard of care to treat symptomatic palpitations due to PVCs with beta blockers; this will not help symptoms of anxiety and it may worsen depression. When seeing patients presenting with palpitations, or patients with chronic heart disease and an ICD, we should consider an evaluation for anxiety and depression.