Atrial fibrillation (AFib) and anxiety are two distinct conditions, but they have more in common than you might think. The symptoms of panic disorder, a type of anxiety disorder, closely mirror those of atrial fibrillation, such as a rapid heartbeat and shortness of breath. Is it possible, then, that anxiety causes atrial fibrillation? This article explores the potential link between these two health conditions.

Understanding AFib and Anxiety

The relationship between atrial fibrillation and anxiety is complex. People with AFib are more likely to develop anxiety following diagnosis, and a significant number of people with AFib also have panic disorder. To understand how anxiety and AFib can affect one another, it’s important to first learn a bit more about these two conditions.

Atrial Fibrillation

In the United States, atrial fibrillation is the most common form of arrhythmia (abnormal heart rhythm). Arrhythmia occurs when the heart’s upper chambers, known as the atria, don’t beat at the same rate as the lower chambers, or ventricles. This lack of coordination results in a rapid, irregular heartbeat. Blood can then pool in the atria, raising the risk of heart failure, blood clots, and stroke.

AFib can be caused by various factors, including heart damage and inflammation. High blood pressure and coronary heart disease, another type of heart disease, commonly contribute to the damage. Changes in the heart’s electrical output and rhythm can also play a role in AFib occurring. Other health conditions may also increase the risk of developing an irregular heart rhythm.

Anxiety

Anxiety disorders are a group of mental health conditions that involve feeling overly fearful and worried during everyday situations. Panic disorder, a type that leads to panic attacks, can be particularly challenging, even debilitating. Panic attacks are episodes of severe anxiety and fear that lead to an intense reaction from your body, known as the fight-or-flight response.

“Fight or flight” is your nervous system’s way of protecting you from an immediate threat — it sets you up to act fast and defend yourself or flee from danger. Your sympathetic (or automatic) nervous system triggers the fight-or-flight response, producing physiological effects such as:

• Increased heart rate
• Faster respiration (breathing)
• Swollen blood vessels in arms and legs
• Higher blood pressure
• Heightened alertness

During an anxiety attack, you experience these effects even though there is no actual threat to your survival.

Can Anxiety Cause AFib?

The relationship between anxiety and atrial fibrillation isn’t well-researched. Not many studies have looked at whether anxiety directly causes AFib, but some evidence does suggest that the mental health condition might have a part in the development of the heart condition.

In theory, there are some potential pathways (connections between nerve cells) through which anxiety could affect AFib. These pathways involve both physical and hormonal factors. During episodes of anxiety, the fight-or-flight response can result in immune cells being sent to the heart and causing inflammation. Chronic (ongoing) inflammation can damage the structure and function of the heart’s cells — a known cause of AFib.

Anxiety also could potentially cause AFib by causing the release of hormones and chemicals during the flight-or-fight response. Chronic release of these hormones could trigger the abnormal heart rhythm seen in the various types of AFib. Although not everyone who experiences anxiety will develop AFib, anxiety and panic disorders are considered risk factors.

Studies investigating whether anxiety causes AFib have produced mixed results. One large study from 2005 looked at people who’d had symptoms of tension (a reaction to an actual situation, or stressor) or anxiety (when there’s no real threat) for 10 years. The researchers reported that men with tension had a high risk of developing AFib and coronary heart disease, but the same result was not found for people who had symptoms of anxiety.

In a smaller study from the ’90s, published in the American Journal of Epidemiology, researchers reported that women experiencing tension and symptoms of anxiety were at greater risk of heart disease.

Further research is needed to determine if anxiety leads to AFib. Understanding this potential link may help health care professionals tailor treatment for people who are at risk. Until then, the jury is out, urging more exploration into the relationship between anxiety and AFib.

Can AFib Be Misdiagnosed as Anxiety?

Misdiagnosing one of these conditions for the other could happen because of anxiety’s and AFib’s similar symptoms, specifically:

• Rapid heartbeat
• Heart palpitations (fluttering)
• Shortness of breath
• Chest pain

Seeing a cardiologist (a specialized heart doctor ) will help ensure that you are given tests that can help lead to the correct diagnosis, such as an electrocardiogram (ECG) to measure your heart’s electrical activity. If they catch an episode of AFib while performing the ECG, they can say that you have atrial fibrillation.

AFib can also be detected outside the clinic using heart-monitor devices that capture heart rhythms during day-to-day activities. If already have an implanted device such as a pacemaker, it can also provide data regarding heart rhythms.

Can Anxiety Worsen AFib?

Researchers have reported that it’s possible for the physical effects of anxiety to prompt or worsen AFib. For example, anxiety can cause high blood pressure and raise your heart rate, which could lead to inflammation in the heart. Damage from the inflammation can increase the risk of heart problems, including AFib.

If you have AFib, knowing that you also experience anxiety may help guide your doctor toward the best treatment plan for you. For example, people who have severe anxiety tend to have more success using medications to control heart rhythm rather than heart rate. It’s important to make sure your health care provider knows about your anxiety, including its severity, so you can get the most effective treatment plan.

Additionally, certain types of ablation — procedures to destroy unhealthy tissue and restore heart rhythm — may increase your risk of an AFib recurrence (return) if you have anxiety. Studies suggest that performing AFib ablation without addressing anxiety may not be effective for managing AFib.

Discuss AFib and Anxiety With Your Doctor

Although anxiety may not be a direct cause of AFib, it may influence the risk of developing and managing this heart condition. Further studies need to be done before researchers and doctors can fully grasp the complex relationship between anxiety and AFib.

Meanwhile, it’s important to recognize the possible link and tell your doctor about your symptoms and medical history regarding anxiety and AFib. Sharing the full picture of your health can help you get an accurate diagnosis and a personalized treatment plan.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Are you living with atrial fibrillation or anxiety — or both? Have you wondered about the relationship between the two conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.