Atrial fibrillation (AFib) and anxiety are two distinct conditions that have more in common than you might think. The symptoms of panic disorder, a type of anxiety disorder, are very similar to those of atrial fibrillation, and can include 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 after 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 learn more about these two conditions.

People with AFib are more likely to develop anxiety after diagnosis, and a significant number of people with AFib also have panic disorder.

Atrial Fibrillation

Atrial fibrillation is the most common form of arrhythmia (abnormal heart rhythm) in the United States. Arrhythmia happens when the heart’s upper chambers, known as the atria, beat at a different rate than the lower chambers, or ventricles. This lack of coordination results in a rapid, irregular heartbeat. Blood can then pool in the atria (upper cavities of the heart), raising the risk of heart failure, blood clots, and stroke.

Atrial fibrillation 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. In the past, AFib was labeled “valvular” or “nonvalvular,” based on suspected causes of the condition. However, these terms are no longer used because the definitions were inconsistent and they became meaningless. 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 of anxiety disorder 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 breathing
• Swollen blood vessels in the 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?

Recent research has explored the relationship between anxiety and atrial fibrillation. Some evidence suggests that mental health conditions might have a role in the development of the heart condition.

Connections Between Anxiety and AFib

Researchers have theorized about 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 lead to immune cells being directed to the heart, causing inflammation. Chronic (ongoing) inflammation can damage the structure and function of the heart’s cells — a known cause of AFib.

Anxiety also can cause AFib through the release of hormones and chemicals during the fight-or-flight 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.

Research Linking Anxiety and AFib

Systematic reviews of studies have reported an association between psychological factors (including anxiety and stress) and episodes of atrial fibrillation. However, there is no substantial proof that one causes the other.

A 2022 meta-analysis of 13 publications found that the risk of AFib is increased by 10 percent among people diagnosed with anxiety. However, anxiety may also be a consequence of AFib symptoms, and it’s still an open question whether one condition causes the other.

A 2022 meta-analysis found that the risk of AFib is increased by 10 percent among people diagnosed with anxiety.

More research is needed to determine if anxiety can actually cause AFib. Understanding this relationship better may help healthcare professionals create treatment plans for people who are at risk and prevent more serious problems. Until then, we still need to explore the link between anxiety and AFib.

Can AFib Be Misdiagnosed as Anxiety?

It’s possible to confuse one condition for the other because anxiety and AFib share similar symptoms, such as:

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

Seeing a cardiologist (a heart specialist) can help ensure you are given the right tests for a correct diagnosis, such as an electrocardiogram (ECG) to measure your heart’s electrical activity. If they notice AFib while performing the ECG, they can tell you that you have atrial fibrillation.

It’s possible to confuse one condition for the other because anxiety and AFib share similar symptoms.

AFib can also be detected outside the clinic using heart monitor devices that check your heart rhythms while you go about your daily activities. If you have an implanted device, such as a pacemaker, it can also provide information about your heart rhythms.

Can Anxiety Worsen AFib?

Researchers have found that the physical effects of anxiety can trigger or worsen AFib. For example, anxiety can lead to high blood pressure and a faster heart rate, which could lead to inflammation in the heart. This inflammation can damage the heart and increase the risk of heart problems, including AFib.

If you have AFib and also experience anxiety, letting your doctor know can help them choose the best treatment plan for you. Your cardiologist can help you find the right treatment options. Managing heart rhythm is a personal process based on symptoms of AFib, the type of disease you have, any other health conditions, and your own goals. It’s important to make sure your healthcare provider knows about your anxiety and understands how severe it is 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 the risk of an AFib recurring (coming back) if you have anxiety. Studies show that doing AFib ablation without addressing anxiety may not be effective for managing AFib.

Discuss AFib and Anxiety With Your Doctor

While anxiety may not directly cause AFib, it may influence patterns related to this heart condition. More studies need to be done before researchers and doctors can fully understand 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.

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