To summarize the conclusions of previous studies, the mechanism of occurrence or recurrence of AF caused by depression may involve the following aspects (16, 17): Anxiety and depression can activate the renin-angiotensin-aldosterone system, play a significant role in promoting cardiac fibrosis, delay atrial conduction and reentry, increase atrial pressure, change atrial electrophysiological remodeling, and thus lead to the occurrence or recurrence of atrial fibrillation. This evidence concerns the gene REN and atrial fibrillation.