# Case Report: rTMS for recurrent major depressive disorder and generalized anxiety disorder comorbid with atrial fibrillation

## TL;DR

This case report explores using rTMS to treat depression and anxiety in a patient with a heart condition called atrial fibrillation.

## Contribution

The study demonstrates rTMS safety and efficacy in treating MDD and GAD comorbid with atrial fibrillation.

## Key findings

- rTMS reduced MDD symptoms by 55% as measured by the PHQ-9.
- Anxiety symptoms decreased by 22.2% using the GAD-7 scale.
- rTMS was well-tolerated in a patient with atrial fibrillation.

## Abstract

This paper examines the utilization of repetitive transcranial magnetic stimulation (rTMS) to treat recurrent Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) in a patient comorbid with atrial fibrillation (AF), a type of common heart arrhythmia. Symptoms of AF can increase the risk of MDD and GAD, negatively impacting quality of life. Repetitive Transcranial Magnetic Stimulation (rTMS) is an FDA-approved modality for treatment-resistant major depressive disorder (MDD) and has shown promise for off-label treatment of anxiety disorders. Quantitative psychometric questionnaires were administered weekly, using the PHQ-9 (Patient Health Questionnaire-9) and GAD-7 (Generalized Anxiety Disorder-7), which revealed symptom reductions of 55% and 22.2%, respectively.