Friday, March 24, 2023

Can Stress Cause Atrial Fibrillation

What Triggers Atrial Fibrillation

How Can Stress Cause Atrial Fibrillation?

When we asked some afib patients about what triggered or brought on their afib episodes, most indicated that no one particular thing triggered them, but most mentioned stress as being a major factor.

One was under extreme stress at work, and was in the process of moving across the country when atrial fibrillation started. Doctors blamed it on marginal high blood pressure, which was probably related to the stress. Another said atrial fibrillation started during a very stressful personal situation while also working in a high-pressure industry, plus just happening to also be “high-strung.” Atrial fibrillation went away for a while but came back when the high stress returned. Chocolate and caffeine were also mentioned as possible additional triggers, which isn’t surprising as we often consume them when under stress. Some also mentioned exercise as being a trigger.

A big challenge for those with atrial fibrillation is that they never seem to be able to anticipate when an afib episode will happen, so understanding some of the common triggers may give some clues.

The concept of triggers, however, is frequently controversial in the afib community. When taken to an extreme, tracking triggers could lead you to cut out things that you might think caused an episode only to find out that some of those triggers really weren’t issues at all. At the Atrial Fibrillation Blog you will find some interesting discussions about commonly-cited triggers, including:

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How Do Various Risk Factors Lead To Afib

Age: Your odds go up as you get older, especially after age 60. In part, thatâs because youâre more likely to get heart disease and other conditions that can cause AFib.

Genes: AFib is a hereditary condition. That means a part of the cause is in the genes you get from your parents at birth. If someone in your close family had or has it, there’s a greater risk for you, too.

Heart disease: Since AFib is a problem with your heart, it’s not surprising that other heart issues raise the chance of having it, including:

Sick sinus syndrome: This isnât the same as the sinuses in your head. The sinus node is a group of cells that control your heartbeat. Think of it as your heartâs own natural pacemaker. Problems with it that can lead to AFib include:

  • Your heart’s electrical signals misfire.
  • Your heart rate alternates between fast and slow.

Heart attack: When the artery that supplies blood to the atria is blocked, it can damage atrial tissue and lead to AFib. But the reverse isnât true. AFib doesnât cause heart attacks.

Heart surgery: AFib is the most common complication. It will happen to 2 or 3 out of every 10 people recovering from a heart operation.

High blood pressure: Itâs the most common condition linked to AFib. It can make the atria, or upper chambers of your heart, get bigger, which makes it work harder

An overactive thyroid gland : It speeds up everything in your body, including your heart.

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What Are Atrial Fibrillation Risk Factors

The risk factors for atrial fibrillation are as numerous as the symptoms.

One of the most important risk factors is existing heart disease. Atrial fibrillation is common among those with coronary heart disease, valve disease, or an inflamed heart muscle or lining, or who have had a heart attack, congestive heart failure, or recent heart surgery. Atrial fibrillation is quite common following valve surgery and coronary artery bypass , the incidence of which can range from 5 to 40 percent following coronary artery bypass.1

Afib can also be found in those with clogged arteries or chest pain , and having diabetes, high blood pressure, or thyroid problems may also increase risk. It’s found in people with lung problems, including asthma, emphysema, pulmonary blood clots, or chronic lung disease.2

In addition, atrial fibrillation can also happen to otherwise healthy people, especially when they are stressed or fatigued, have had too much caffeine or alcohol, have smoked, or have exercised too much. Other causes that are frequently mentioned include heart and other medications, recreational drugs, air pollution, chemicals and pesticides, and H. Pylori, which is often associated with ulcers. Another known risk factor is having too much or too little of some minerals in your body, such as calcium, magnesium, or potassium.

Arrhythmia And Panic Attacks

Atrial fibrillation &  Atrial flutter

Arrhythmias are often harmless, especially when related to anxiety. Most anxiety-related arrhythmias have little to no effect on the heart and can occur in individuals who are extremely healthy.

But arrhythmias often make anxiety symptoms worse and may trigger panic attacks. Arrhythmias may even be one of the more common panic attack triggers. In fact, it is very common for people to experience his or her first panic attack during a time of heart arrhythmia and for that person experiencing his or her first panic attack, thoughts often arise around something being terribly wrong with the heart, thus increasing anxiety and panic.

While it is much more common for arrhythmias to trigger panic attacks, it can go the other way around, with ongoing panic attacks contributing to the development of arrhythmias.

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Can Anxiety Cause Afib

While they are two separate issues, there are studies that suggest anxiety can trigger Afib episodes. This can be good news and bad news for those who suffer from anxiety.

It’s not the easiest thing to do, but those with AfIb can lower their chances of an episode by finding ways to keep their stress levels down. Anxiety can make Afib worse, so avoiding any kind of anxiety triggers is even more important than usual for people who have both.

Is Your Heart Racing From Anxiety Or An Arrhythmia

Heart palpitations. Chest pain. Sweating. A strangefluttering sensation in your chest.

These are common symptoms of anxiety or a panic attack, but they are also signs of a dangerous heart condition called atrial fibrillation, or irregular heartbeat. Although we all experience moments of heightened stress or excitement when our hearts seem to skip a beat its important to recognize when what youre feeling is something more serious.

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Does Stress Cause Atrial Fibrillation

Atrial fibrillation is so sneaky. So is afib really stress in disguise? Afib seems to sneak up on you when you least expect it and you wonder where did that come from? Its hard to pin down an atrial fibrillation cause or trigger when its different every time.

For some, its triggered by alcohol or caffeine. For others, by certain types of foods or food additives. For some, it may come on during exercise or from something as simple as bending over. For still others, eating late or sleeping on the left side triggers it. It varies all across the board.

In medical information you rarely see mention of stress causing afib, but I think that stress is a huge contributor. Of the patients Ive interviewed, about 3/4 said that stress was a huge component in bringing on their afib episodes.

Stress certainly could be a factor that leads us to indulge in alcohol, caffeine, or certain foods. But is the food the cause, or is the stress the actual root cause?

Heres a short video clip of what triggered my afib:

Types Of Ventricular Arrhythmias

How Does Stress Affect Your Atrial Fibrillation?

A ventricular arrhythmia begins in the hearts ventricles.

Types of ventricular arrhythmias include:

Premature ventricular contractions

Early, extra heartbeats that originate in the ventricles. Most of the time, PVCs dont cause any symptoms or require treatment. This type of arrhythmia is common and can be related to stress, too much caffeine or nicotine, or exercise. They can be also be caused by heart disease or electrolyte imbalance. People who have several PVCs and/or symptoms associated with them should be evaluated by a cardiologist .

Ventricular tachycardia

A rapid heartbeat that originates in the ventricles. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body. V-tach can be serious, especially in people with heart disease, and may be associated with more symptoms than other types of arrhythmia. A cardiologist should evaluate this condition.

Ventricular fibrillation

An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and cannot generate an effective contraction, which results in a lack of blood being delivered to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation and defibrillation as soon as possible.

Long QT

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The Difference Between Panic Attacks And Afib

Atrial fibrillation and anxiety attacks share some principal symptoms, including episodes of irregular heart rhythm, and worrying about the cause can only make it worse. However, the two syndromes are actually quite different in nature. While AFib is a physical disorder involving abnormal electrical, anxiety is an emotional disorder that can be trigged by a number of reactions, situations or stimulants.

Although different people can experience symptoms differently, there are a few indicators that your chest discomfort is likely a panic attack:

  • Gradual heart rate decline. AFib episodes typically come on suddenly and leave without notice, but heart rate tends to gradually return to normal as a panic attack ends.
  • Fast, but regular heartbeat. A panic attack provokes a constant rapid heart rate. In contrast, AFib typically causes an erratic heart rate, where the beats speed up for a few seconds, then slow, then speed up again.
  • Emotional component. During panic attacks, it can feel like the world is about to end fear, helplessness and a sense of impending doom are commonly reported. AFib, on the other hand, is a strictly physical occurrence that generally doesnt bring emotional upset.

Common Treatment For Afib May Lower Anxiety Depression

Levels of anxiety and depression seen in people who have a common heart rhythm disorder called atrial fibrillation may be affected by how the heart condition is treated, a new study suggests.

Past studies have shown that anxiety, distress and depression are common among people with AFib. The new Australian study, published Tuesday in the Journal of the American Heart Association, looked at personality traits and levels of anxiety and depression in 78 patients who had sought treatment for the disorder. Twenty chose to have an ablation, a procedure that destroys the heart tissue causing the abnormal heartbeat the other 58 were on medications to control their heart rate and prevent blood clots.

When the study began, 35 percent of the participants reported experiencing severe anxiety and distress and 20 percent reported having had suicidal thoughts. One year later, the researchers found that the patients who had an ablation were less likely to report feelings of anxiety and depression than the patients taking medications. In addition, the number of patients in the ablation group with suicidal thoughts dropped from six to one.

The studys senior author, Jonathan Kalman, an electrophysiologist at the Royal Melbourne Hospital in Australia, said the study demonstrates that effective treatment of atrial fibrillation markedly reduces psychological distress.

Patel, who was not involved in the study, said the studys small size limited what could be construed from the findings.

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What Other Heart Issues Can Be Caused Due To Stress

Over the years, stress has been linked as a direct and indirect cause of many heart issues, including arrhythmias. The presence of chronic stress and high cortisol levels can contribute to an increase in cholesterol, triglycerides, blood sugar, and blood pressure levels. By doing so, stress is indirectly contributing to heart disease, since all of the previously mentioned events are known risk factors for heart disease.

Chronic stress can also increase the thickness of blood, making it more likely for blood clots to form. Such an event increases the risk of stroke, although not a heart issue, is still a life-threatening health issue.

But did you know that stress can directly damage your heart? That is by causing a condition known as stress-cardiomyopathy.

Stress-cardiomyopathy is also known as broken heart syndrome.

This condition is caused as a result of intense physical or emotional stress, which causes severe damage to the heart muscle. Stress-cardiomyopathy is a potentially life-threatening condition and requires proper treatment right away.

How Stress May Trigger An Afib Episode

Atrial Fibrillation (AF) and HRV

During times of stress, your body releases stress hormones that can increase your blood pressure and trigger an AFib episode. Stress can arise from many aspects of your daily life. The two main types of stress, physical and emotional, have varying effects on your body.

Physical stress includes sleep deprivation, sickness, injury, and dehydration. Emotional stress occurs when you experience negative emotions including sadness, anger, and fear.

It is very common for unhealthy habits to arise from stress. Habits such as poor diet and alcohol or caffeine consumption can increase your blood pressure and trigger an episode. In order to manage your episodes, its necessary to find healthy ways to manage your stress.

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Ways To Reduce Stress When You Have Atrial Fibrillation

Need to calm yourself, and your heart rhythm, down? Relax, we have some research-backed ways to keep stress from triggering or worsening afib.

Stress is an undeniable part of most of our lives. Were bombarded daily with myriad reasons to feel stressed or anxious, from political news and financial worries to illness and work woes. Stress is clearly understood to be psychologically taxing, but evidence is piling up that points to its physiological effects as well. One clear example is the way in which chronic levels of stress impact your heart and cardiovascular health overall.

That effect is amplified if you already have a cardiovascular condition. For people with heart arrhythmias like atrial fibrillation, or afib the most common form of heart rhythm abnormality stress may trigger or worsen episodes. An estimated 2.1 to 6.7 million Americans have afib, according to the Centers for Disease Control , and this number is expected to rise as the population ages.

In afib, electrical activity that normally regulates heart rhythm is out of whack, making the upper chambers of the heart beat erratically, says Eric J. Rashba, MD, director of the Heart Rhythm Center at Stony Brook University Heart Institute in New York. Over time, poor blood flow to the area can prompt clots to form, and lead to a far higher risk of stroke.

More Stress Means More Complications

In a study of 100 patients with intermittent AFib, the impact of stress was clear: 54% of participants reported that not only was stress a concern, but it was the cause of a majority of their attacks.

At the best of times, stress is simply an annoyance, but as it builds, it can lead to more significant problems. For some, stress triggers depression and general anxiety, and if left unchecked, these can counteract all your best efforts to control your AFib. After all, dwelling on AFib symptoms and the fact that they could strike again will feed anxiety, and anxiety will feed your symptoms.

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Triggers For Atrial Fibrillation: The Role Of Anxiety

Paolo Severino

1Department of Cardiovascular, Respiratory, Anesthesiology, Nephrology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy

2Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

3Department of Neurosciences and Mental Health, Umberto I Policlinic, Rome, Italy


Atrial fibrillation is the most widely recognized arrhythmia. Systemic arterial hypertension, diabetes, obesity, heart failure, and valvular heart diseases are major risk factors for the onset and progression of AF. Various studies have emphasized the augmented anxiety rate among AF patients due to the poor quality of life however, little information is known about the possibility of triggering atrial fibrillation by anxiety. The present review sought to underline the possible pathophysiological association between AF and anxiety disorders and suggests that anxiety can be an independent risk factor for AF, acting as a trigger, creating an arrhythmogenic substrate, and modulating the autonomic nervous system. The awareness of the role of anxiety disorders as a risk factor for AF may lead to the development of new clinical strategies for the management of AF.

1. Introduction

2. Pathophysiological Insights for the Link between AF and Anxiety Disorders

Moreover, stress response has been described as resulting from a fight or flight reaction that can be the result of endocrine, nervous, and immune systems .

3. Discussion

4. Conclusions

Conflicts of Interest

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