# Core and bridging symptoms in patients with atrial fibrillation: a network analysis

## TL;DR

This study maps symptom relationships in atrial fibrillation patients to identify key and connecting symptoms for better management.

## Contribution

The study constructs a symptom network for atrial fibrillation and identifies core and bridging symptoms.

## Key findings

- Core symptoms include 'shortness of breath during physical activity' and 'shortness of breath at rest'.
- 'Shortness of breath at rest', 'palpitations', and 'chest pain' act as bridging symptoms between symptom clusters.
- Mental health scores are closely related to 'fatigue at rest', and sex influences most symptoms.

## Abstract

Atrial fibrillation symptoms are diverse and complex, but symptom networks can visually map the relationships between symptoms and influencing factors, identifying key symptoms and offering better targets for symptom management. However, research on establishing symptom networks in Atrial fibrillation patients is limited.

We aimed to construct a symptom network for patients with atrial fibrillation, understand its characteristics, and identify core and bridging symptoms.

This cross-sectional study enrolled 384 patients with atrial fibrillation from November 2021 to August 2022 at Tianjin Medical University General Hospital of China. Network analysis methods were utilized to construct the symptom network. Centrality metrics were used to identify important symptoms.

By incorporating covariates into the symptom network, we revealed that the Mental Health Inventory-5 score was most closely related to “fatigue at rest”. Sex influenced all symptoms except “dizziness” and “shortness of breath at rest”. Left ventricular ejection fraction was closely connected to “exercise intolerance” and “shortness of breath at rest”, while the frail score was closely linked to “exercise intolerance” and “dizziness”. Controlling for covariates, “shortness of breath during physical activity” and “shortness of breath at rest” are atrial fibrillation patients' core symptoms. “Shortness of breath at rest”, “palpitations”, and “chest pain” served as bridging symptoms between symptom clusters.

Symptom networks can help us understand the relationships between symptoms and influencing factors, as well as the interactions between different atrial fibrillation symptoms.