A world-first trial, known as SAD-AF, will be looking at the potential impact on whether medication used for clinically diagnosed depression can improve atrial fibrillation (AF) in patients.
Researchers from the Royal Melbourne Hospital (RMH) will be evaluating the effects of selective serotonin reuptake inhibitors (SSRIs) on AF-related symptoms as well as the quality of life in individuals with depression.
Study coordinator and electrophysiology fellow at the RMH, Dr Youlin Koh says despite multiple studies noting the relationship between symptoms of depression and AF, there is a need for further investigation to delineate the downstream impact of treating mental illness in AF patients.
“What we hope to achieve with this study is to examine the effects of selective serotonin reuptake inhibitors on heart rhythm,” said Dr Koh. “The autonomic [fight or flight] nervous system is dysregulated in both AF and depression, and these serotonin-based antidepressants have shown improvements in autonomic function in patients with depression.
“We think that through autonomic regulation, they can also reduce AF episodes, showing a dual action on the brain and the heart.
“We will evaluate the effect of selective serotonin reuptake inhibitors on changes in AF related symptoms as measured by the AF effect on quality-of-life questionnaire (AFEQT),” she added.
Through a randomised controlled trial, participants will be assigned either a selective serotonin reuptake inhibitor or a placebo. Various methods, including smartphone app-based ECG recordings, seven-day Holter monitoring, and existing cardiac implantable electronic devices, will be used to measure the amount of time spent in AF.
“The SAD-AF study holds immense promise in unravelling the effects of selective serotonin reuptake inhibitors on AF-related symptoms and quality of life,” said Dr Koh.
“By shedding light on the benefits of treating depression, this research has the potential to transform patient care and revolutionise the management of AF,” she added.
“There are currently limited medication options for the treatment of AF and patients often have side effects from them. It would be great for patients to have an extra medication option, especially since selective serotonin reuptake inhibitors are commonly used and have a track record of safety.”
Recruitment for the SAD-AF study is currently underway, and the ground-breaking trial is currently recruiting at the RMH, with recruitment at Alfred and Western Health to follow soon. For more information on the trial, please contact the team on 0424 637 336.
This work has received support from NHMRC and the Heart Foundation.
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