Psychological stress is recognised as a contributing factor in initiating and heightening the most common irregular heart rhythm, atrial fibrillation.
And while there is a growing body of literature linking stress with a range of cardiovascular diseases there is still much more work to be done in defining this.
In a review published in JACC: Clinical Electrophysiology, researchers from the Baker Heart and Diabetes Institute and The Alfred Hospital highlight potential mechanisms linking stress and atrial fibrillation, and the possible use of stress reduction in its management.
It is estimated more than 500,000 people in Australia suffer from atrial fibrillation. Atrial fibrillation is an irregular and often rapid heart rhythm that can lead to blood clots forming in the heart. People diagnosed with atrial fibrillation are at increased risk of stroke, heart failure and other heart-related complications. Atrial fibrillation also leads to increasing anxiety, depression and suicidal ideation.
There is significant global variation in people reporting psychological stress, but on average it is reportedly experienced by 1 in 3 people. Reported stress levels have been on the rise annually with the COVID-19 pandemic leading to an even larger increase in self-reported psychological distress.
“We are seeing that psychological stress and even negative emotions are associated with initiation and heightening of atrial fibrillation” says senior study author, Professor Peter Kistler. “By recognising stress as a potentially modifiable risk factor in these patients, we can develop a more holistic management approach. As such, targeted stress reduction may improve symptom perception and outcomes for patients with atrial fibrillation.”
The researchers examined studies on the role of stress in this disorder, as well as modifying traditional atrial fibrillation risk factors such as diet, alcohol cessation and exercise.
“Recently, lifestyle modification has emerged as an important pillar of atrial fibrillation management, with stress reduction a potential reversible risk factor and future target for intervention,” Professor Kistler says.
The review also focuses on the bidirectional nature of the atrial fibrillation and stress relationship. It looks at the role of acute and chronic stress in inducing atrial fibrillation; the role stress plays on physiologically changing the heart; gender differences in response to stress; as well as how to measure stress, which is often subjective and self-reported.
