Can stress cause atrial fibrillation?

My name is Sanjay Gupta and I am a cardiologist in York. One of the commonest questions i get asked by patients suffering from atrial fibrillation is:

Can stress cause atrial fibrillation?

Today’s blog is therefore on the subject of emotional stress and how it can trigger Afib.

This is a subject that is very close to my heart because whilst everyone believes that the reason there is so much illness about is because of an aging population, i have always maintained that it is more to do with lifestyle. And whenever lifestyle is mentioned people assume that lifestyle relates to exercise and diet. However to my mind perhaps the most important yet most neglected component of lifestyle is stress.

We live in a hugely stressful world and stress is everywhere and to my mind stress is perhaps the single biggest cause of morbidity and mortality and it is unfortunate that our politicians are happy to give millions of pounds to pharamceutical companies to bring wierd and wonderful drugs to treat medical illnesses, they don’t invest at all in strategies to help reduce stress and thereby prevent disease from happening in the first place. And the simple reason for this is that preventing disease is not as profitable as treating disease!

We know stress is hugely inflammatory to the body and most chronic western world illnesses arise from long term chronic inflammation.

This week, I found a very interesting study in the journal of American college of cardiology and this was published in Oct 2014. The lead author is Rachel Lambert and the study was called ‘triggering of symptomatic atrial fibrillation by negative emotion’

95 patients paroxysmal AF were studied.All were in sinus rhythm at the time of enrollment.
They were asked to keep an electronic diary summarising their emotions for the day at the end of each day for a whole year. They were asked to fill in if they had been happy, sad, angry, stressed, impatient, anxious or hungry.
They were given a loop recorder so that they could record their symptoms when they felt that they had gone into Afib and then they were also asked to fill in exactly what their emotions were just before theu developed their symptoms.
Once a month, they were also given a 24 hour tape and every 30 minutes they were asked to fill in how they were feeling.

So the researchers then used the result to compare 2 things:

  • Did emotional status influence whether you had an Afib attack on the same day?
  • Did emotional status on the day before impact on whether you had an Afib attack the next day?

The results were amazingly interesting!

  • Stress, Anxiety and sadness and anger all increased the likelihood of Afib
  • Happiness was incredibly protective

In fact the likelihood of AF events was 85% lower after reports of happiness!

They also found that if the patient had reported being stressed or angry the day before then this almost doubled the likelihood of AF on the following day. The more the stress the more likely an episode of AF!

So in summary this study very elegantly showed that negative emotion can trigger Afib.

And this is why i think that being mindful of the huge negative impact that stress can have on our health is so important and giving priority to those aspects of your life that genuinely give you happiness and destress you is a very worthwhile investment.

Here are some more videos on the subject of Afib

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