Panic features strongly predict the subjective but not the objective benefit of pulmonary vein isolation

  • Jürgen C. P. J. KnobelEmail author
  • Sieberen P. Van der Werf
  • Fons F. Van den Berg
  • Jonas S. S. G. De Jong



Clinically observed discrepancies between electrocardiogram findings and subjective report of symptoms related to atrial fibrillation (AF) often remain unexplained. One could hypothesize that after a technically successful ablation, preoperative panic behavior might affect the report of AF-related symptoms. However, research on comorbid panic behavior in patients with AF is limited.


In this observational prospective cohort study, we investigated psychological characteristics, in particular the prevalence of panic features, among 112 patients with AF and its possible influence on experienced outcome of subsequent ablation treatment.


Twelve percent of the AF patients (n = 12) were pre-operatively characterized by panic features. This group experienced higher levels of distress and more limitations in daily life compared to AF patients without panic features, but was not characterized by higher levels of neuroticism. However, AF-ablation resulted in a similar reduction of experienced limitations in daily functioning and levels of distress in both groups.


Patients with panic features experience more distress and more limitations in daily life from AF, but these complaints are reduced by AF ablation in a similar rate as in patients without panic features. Additional psychological therapy is suggested as a method to further reduce subjective AF disease burden in these patients.


Panic Atrial fibrillation Ablation Outcome 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.OLVG Hospital Psychiatry & Medical PsychologyAmsterdamNetherlands
  2. 2.University of AmsterdamFaculty of Social and Behavioural SciencesAmsterdamNetherlands
  3. 3.Rijnstate Hospital, Medical PsychologyArnhemNetherlands
  4. 4.OLVG Hospital, Heart CenterAmsterdamNetherlands

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