Atrial fibrillation (AF) is the most commonly seen arrhythmia in clinical practice. At present, few studies have been conducted centering on depression and anxiety in AF patients. Our aim in this systematic review is to use the relevant literature to (1) describe the prevalence of depression and anxiety in AF patients, (2) assess the impact that depression and anxiety have on illness perception in patients with AF, (3) provide evidence to support a hypothetical connection between the pathophysiology of AF and depression and anxiety, (4) evaluate the benefit of treatment of AF on depression and anxiety, and (5) give insight on medically managing a patient with AF and concomitant depression and anxiety. 1. Introduction Atrial fibrillation (AF) is a cardiovascular epidemic which affects more than 3 million individuals in the United States alone [1, 2]. Diabetes, congestive heart failure, hypertension, aging of the population, male gender, and obesity are just a few risk factors which increase the incidence of AF [3, 4]. AF is associated with significant morbidity and mortality. At present, many conducted studies assess the impact of AF on health-related quality of life (HRQOL) [5]. However, limited information on depression and anxiety in patients with AF exits. Our aim in this comprehensive systematic review is to use relevant literature to the (1) describe the prevalence of depression and anxiety in AF patients, (2) assess the impact that depression and anxiety have on illness perception in patients with AF and vice versa, (3) provide evidence to support a hypothetical connection between the pathophysiology of AF and depression and anxiety, (4) evaluate benefit of treatment of AF on depression and anxiety, and (5) give insight on medically managing a patient with AF and concomitant depression and anxiety. 2. Methods 2.1. Data Sources and Searches A detailed literature search was conducted using electronic databases including PubMed, MD Consult, and PsycINFO from their inception through January 2012. One of the investigators, with the help of a qualified medical librarian, did the electronic search. All designs of studies (observational, cross-sectional, case-control, and cohort studies) on depression and anxiety in AF patients were considered. The following search key terms were used: atrial fibrillation, depression, anxiety, catheter ablation, cardioversion, and antiarrhythmic drugs. Only articles printed in the English language were included. Once studies were retrieved, abstracts were screened, followed by full-article review and assessment for
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