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 (CDC), 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. What does stress have to do with it? Most significantly, stress can exacerbate some of the underlying conditions that cause afib, such as high blood pressure. “People who are under stress are more likely not to eat well or take care of themselves and are prone to the kind of conditions that lead to afib," says Dr. Rashba, adding that responding to everyday stress by, say, drinking to excess, can bring on an episode of afib, as alcohol consumption is a known trigger for the condition. Although, as Rashba notes, researching stress’s effect on afib is difficult (it’s impossible in a lab setting to give one group of people stress and make sure another group is not stressed), there are studies that point to a connection, at least to the ways in which stress leads to behaviors that may worsen afib. In a study published in the Journal of Cardiovascular Medicine, researchers looked at 400 people who had experienced an initial episode of afib. Via cognitive tests and patient interviews, they found that acute stress led many to make lifestyle changes, such as overeating and overconsuming coffee, that may have precipitated their episode. Finally, just having afib, particularly for the long term, leaves many sufferers more depressed and anxious than their same-age peers, found a study published in 2018 in the journal Cardiology Research and Practice. This should prompt healthcare providers to check in with patients to evaluate stress and anxiety levels, and perhaps suggest ways to reduce stress. To mitigate the effects of stress on atrial fibrillation, it makes sense to find ways to stay calmer and cooler. Here are four research-backed means of doing just that:
1. Yoga
It isn’t easy to call to mind the picture of an anxious-looking yogi. There are good reason for that. Yoga training has long been linked to better cardiovascular health, among other physical and mental benefits. In a small study reported in March 2013 in the American Journal of Cardiology, people with paroxysmal afib who practiced yoga twice a week experienced a reduction in afib episodes. Immediately post-training, their blood pressure and heart rate were lower, and overall the participants had less anxiety and improved overall quality of life.
2. Biofeedback
This intriguing practice involves using what’s called “self-regulation” to exert a positive impact on physiological processes, such as heart rate. Think of biofeedback like meditation, but using a monitoring device to help you track your physiological data and use that as a means to train yourself to control your physiological response. This approach can be used for the management of afib, particularly to control ventricular rate. In a small report published in February 2015 in the Journal of Thoracic Disease that compared the usefulness of various alternative therapies in treating afib, biofeedback training got high marks for its ability to help people decrease their heart rate and potentially manage afib.
3. Meditation
We all know people who seem enviably calm and who attribute their ability to stave off stress to the practice of some form of meditation. It seems intuitive that any regular meditative practice would elicit a calming effect, both psychologically and physiologically. Recent research published in May 2018 in Frontiers in Physiology, jointly undertaken by the University of North Texas and the U.S. Army Research Laboratory, zeroed in on a novel way to quantify stress — in terms of heart-rate variability — and thereby to judge how well meditation can reduce it. The study concluded that although various forms of medication are effective at reducing stress in the immediate term, the long-term practice of meditation made positive physiological changes permanent.
4. Exercise
There’s no question that regular physical activity can reduce stress. The key to how it works specifically for afib is twofold: First, exercise that leads to even a modest amount of weight loss can help you lower blood pressure and reduce your risk for sleep apnea, two conditions that are major triggers for afib, says Rashba. “Blood pressure, in particular, when it’s uncontrolled puts increased pressure on the heart over time, causing the muscle to become stiffer and the atrium that’s affected by afib to stretch, and the more that happens, the more often the heart goes into and stays in afib.” But exercise that relieves stress also may have the benefit of helping you make other, healthier habits, such as drinking less and quitting smoking. Although there are successful medical treatments for afib, such as medication and ablation — a procedure that cauterizes the faulty electrical connections that lead to episodes — improving the conditions that trigger fibrillation by reducing stress has great promise. Your mind can be your greatest ally in improving your heart health.
