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CASE REPORT article

Front. Psychiatry

Sec. Anxiety and Stress Disorders

Case Report: rTMS for Recurrent Major Depressive Disorder and Generalized Anxiety Disorder Comorbid with Atrial Fibrillation

Provisionally accepted
Vipul ReddyVipul Reddy1*Nadia FrutkinNadia Frutkin1,2Abeer SinghAbeer Singh1,3Manya PappuManya Pappu1,4Khimaya RavalKhimaya Raval1,2Mark OdronMark Odron1Charles VigiliaCharles Vigilia1Kenneth BlumKenneth Blum5,6,7,8,9David BaronDavid Baron10Keerthy SunderKeerthy Sunder1,11,12,5
  • 1Division of Clinical Neuromodulation Research, Karma TMS, Palm Springs, United States
  • 2Palm Desert High, Palm Desert, United States
  • 3La Quinta High, La Quinta, United States
  • 4Taft Charter High, Woodland Hills, United States
  • 5Western University of Health Sciences, Pomona, United States
  • 6Institute of Psychology, Eotvos Lorand Tudomanyegyetem, Budapest, Hungary
  • 7Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, United States
  • 8Institute of Integrative Omics and Applied Biotechnology, Purba Medinipur, India
  • 9Sunder Foundation, Palm Springs,, United States
  • 10Western University of Health Sciences, Pomona, CA, United States
  • 11Sunder Foundation, Palm Springs, United States
  • 12Department of Psychiatry, University of California Riverside School of Medicine, Riverside, United States

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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.

Keywords: Atrial Fibrillation (AF)7, Dorsolateral Prefrontal Cortex (DLPFC)2, GAD-7 (Generalized Anxiety Disorder-7 item scale)6, Major Depressive Disorder (MDD)4, neuromodulation3, PHQ-9 (Patient Health Questionnaire-9)5, Repetitive Transcranial Magnetic Stimulation (rTMS)1

Received: 06 Oct 2025; Accepted: 09 Feb 2026.

Copyright: © 2026 Reddy, Frutkin, Singh, Pappu, Raval, Odron, Vigilia, Blum, Baron and Sunder. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Vipul Reddy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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