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Background The effects of anxiety and depression on the recurrence of persistent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA) are not clear.Whether CPVA can alleviate the anxiety and depression symptoms of persistent AF patients is unknown.Methods One hundred and sixty-four patients with persistent AF,of which 43 treated with CPVA (CPVA group) and 103 treated with anti-arrhythmics drugs (medicine group),were enrolled.The Zung Self-Rating Anxiety Scale (SAS),and Zung Self-Rating Depression Scale (SDS) were assessed before and 12 months after treatment in all patients.Results The scores of SAS (40.33±7.90 vs.49.76±9.52,P ＜0.01) and SDS (42.33±8.73 vs.48.17±8.77,P ＜0.01)decreased 12 months after CPVA.Over 12 months follow-up,AF relapsed in 17 patients in CPVA group.Compared with the data in the recurrent group (17 patients),the scores of SAS and SDS were significantly lower in the non-recurrent group (26 patients) at baseline.The results of multivariate Logistic regression analysis showed normal scores of SAS and SDS were the independent risk factors of AF recurrence after CPVA.Conclusions Anxiety and depression increase the recurrence risk of persistent AF after CPVA.CPVA can ameliorate the anxiety and depression symptoms in patients with persistent AF.