Anxiety and depression symptom networks before and after catheter ablation for tachyarrhythmia: a prospective longitudinal study

INTRODUCTION The evolution and relationship between anxiety and depression symptoms are complex and may vary between before and after catheter ablation for tachyarrhythmia. The present study aimed to explore the evolution and relationship between anxiety and depression symptoms by using network analysis. METHODS Longitudinal data were selected from a cohort study of individuals with tachyarrhythmia. The Hospital Anxiety and Depression Scale was used to examine anxiety and depression symptoms at baseline, and one and three months postoperatively. Cross-sectional networks and cross-lagged panel networks (CLPN) were constructed to identify important predictors. RESULTS 344 patients were included in the network analysis. Moderate-to-high levels of congruity were observed across three cross-sectional networks. A3 (Worrying thoughts) had higher strength centrality across all time points. Meanwhile, the strength centrality at the three time points is time-specific. Specifically, the node with the highest strength centrality was D3 (Cheerful feeling) at T1, but A4 (Relaxed feeling) at both T2 and T3. Additionally, A3 (Worrying thoughts) and A4 (Relaxed feeling) had a higher bridge strength centrality across all times. The cross-lagged network revealed that A3 (Worrying thoughts) and A4 (Relaxed feeling) could predict the subsequent presence of multiple anxiety-depression symptoms at T1 to T2 CLPN and at T2 to T3 CLPN, respectively. CONCLUSION This study elucidates the complex evolutionary patterns and interactions between anxiety-depression symptoms in patients with tachyarrhythmia during the perioperative period of catheter ablation. Worrying thoughts and Relaxed feeling are central symptoms that may inform the prioritization of clinical focus for alleviating anxiety and depression.