A longitudinal cohort and mendelian randomization study suggested there was a modest, but significant longitudinal and causal relationship between neuroticism and atrial fibrillation (AF). In 394,834 UK participants (mean age 56.3 years, 45.9% male), AF occurred in 23,509 (6.0%) during a 10-year follow-up. Based on the median summary score from a self-questionnaire of 12 neurotic behavior domains, the risk of incident AF significantly increased in the high neuroticism score group (score ≥4, inverse probability of treatment weighting–adjusted HR: 1.05) compared with the low neuroticism group. In the subgroup analysis, younger age, lower body mass index, or nonsmoker/ex-smoker participants were particularly susceptible to increased AF risk due to high neuroticism scores. A Mendelian randomization analysis of the UK and another European genome-wide association studies confirmed a significant causal relationship between an increase in neuroticism score and increased risk of AF (OR by inverse variance–weighted method 1.06) without evidence of reverse causality. Individuals with high neuroticism who are more susceptible to depressive symptoms have also shown higher risk for developing heart failure and myocardial infarction in a recent study. The findings suggest that mental health screening and management of risk factors may be beneficial. Source: https://www.jacc.org/

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