afib and stress and anxiety

I have been diagnosed with afib and have undergone the ablation procedure. I was told after the procedure that it was cured. I continue to have episodes and i continue to take medicine. I feel strongly that there is a connection between my afib and the anxiety stress and insomnia that i have experienced over the years but my doctor disagrees. Does anyone have an opinion on the issue?

43 Replies

  • You may not like this, but my view is that the source of anxiety, stress, insomnia, and a host of other experiences lies squarely between our ears. Arrhythmias are just that - irregular heartbeats. They don't come with psycho-emotional baggage attached; we add that stuff in the ways we react to it. We can choose our response, and it doesn't have to be anxiety, etc. With practice, mindful attention and awareness do wonders for calming the runaway horses in our heads.

  • Great answer.......trying to work more on what's between my ears!!!! Have become very neurotic and obsessed with every sensation in my heart. Meditation and mindfulness is the answer now if I would just embrace that!

  • It sounds like you're emotionally involved with fear. If you really pay attention to what's happening you'll note that you haven't died yet. That should settle your most primal fear.

    Don't bother embracing anything. Just keep watching and you'll note that you're still alive. Continue. Then watch your feelings and note (on paper, if possible) the various emotions as one morphs into another. I'll bet you no individual emotion lasts longer than 30-45 seconds.

    You can't maintain a terrified vigilance, and eventually you'll start to trust your heart. You might as well do that sooner than later. What do you want - to stress yourself out about something you have no control over, or to manage what you do have control over (that would be your mind)?

    All these suggestions will fail. When they do, just breathe. Feel your aliveness in all its irregularity. You are alive and your body is doing just what it needs to do under the circumstances. Then take your meds and go about your business.

    And don't forget to laugh.

    Finally, ignore this advice. :-)

  • You are right on. Which country are you in kodaska? Just wondering. You need to get on the afib presenters calendar. Your head is on right. How long have you had afib and how old where you when it came on?

  • Hi Eliza,

    Thanks for the nice compliment. I'm in southern Wisconsin, USA. My head may be on right, but it doesn't stay there all the time! I just share stuff that works for me and others, when we remember to practice it.

    My first experience of a-fib was flutter that started in the spring of 2013, when I was not quite 64. I was breaking camp during a solo wilderness canoe trip in Minnesota, not far from the Canadian border. Two days later I got to the nearest hospital where it converted with the help of amiodarone.

    The flutter came back intermittently and I had an ablation in April 2014. A-fib developed and I had another ablation a year later, this past May. Now I have a flecainide-induced autoimmune disorder. What I suggested about paying attention and not worrying about stuff you can't control describes much of my own practice dealing with the ongoing symptoms of dizziness, fatigue, paresthesia, and bleary eyes.

    That's more than you asked for, but the additional info might be useful, or at least interesting.

    ~ Koda

  • I'm in USA too and my daughter lives in Milwaukee. I used to before we moved to Florida some 15 years ago. I'm wondering if it was you who wrote about the flecinide some months ago and the horrible side effects that can come with it. It made me very sick for the short time I was on it but my sister takes 300 mg everyday just for occasional palpitations. How long were you on this drug? I've informed her but she puts lot of faith in her EP.....this drug is so widely prescribed!!!!!!

  • Small world ... I used to live in Milwaukee, back in the '70s. I'm in Stoughton now. Yes, 'twas I who wrote about flecainide and its side effects. I was on it for five weeks. I discontinued it because of the side effects.

  • Firstly, I don't think it was wise for you to be told you are 'cured' after the ablation. My strongest advice to you would be to read all the little blue boxes below your post and take in some of the very good advice and observations made on this site. The very best of luck to you, we all can feel the fear - you are not alone!

  • My AF came after huge amounts of stress due to social workers and drs. Left us running around doing 250 milectrips to see a father in law who just wanted cipsvif tea!!!! Hubby was I'll. Had a vile boss.

    Yes I believe stress caused mine.

  • When is ablation No 2? One ablation might not be a cure but ablation therapy (which could involve two, three or more procedures) probably will be. Get on that waiting list as soon as possible and you'll find sunshine breaking through those cloudy skies.

    Ablation cured me.

  • Hi Angold,I went into afib some 12 years ago at a time in my life of high stress and have seen a workmate get afib in very similar circumstances though I have also been a fairly large consumer of alcohol.After an ablation last year I have a fairly regular heartbeat but no p wave ativity

  • Like me, you may well have AF influenced by the Vagus Nerve which connects the brain via the heart to the stomach. My AF kicked off in 2008 when I had a perfect storm of stress and whereas it was probably not the only cause I have no doubt it was a strong contributive factor.

    Follow your instincts, change your lifestyle/diet/supplements and include your medics as part of 'the team' only. It will take time but be persistent, after all it took a while for your body to start AF and it will take a while to stop it. Good Luck!

  • Interesting ... my first experience with a-fib was flutter in a totally stress-free environment. I was on a wilderness canoe trip in the Boundary Waters (on the border between Minnesota and Canada), just about the most relaxing activity I can imagine. It was early morning on a beautiful day and I was breaking camp, looking forward to a day of paddling and finding another campsite.

    It started (I'll try to put this as delicately as possible) when I was on the latrine and gave a push. When I got to the nearest hospital two days later, the ER (or A&E, as you say) nurse said it was most likely caused by the vagus nerve. My friend the cardiac nurse tells her patients with a-fib to push as though they were constipated or having a baby. She says sometimes the same thing that starts it can stop it.

  • Yes Kodaska that all sounds correct and like the Vagus Nerve to me.

    It is frustrating in that it can kick off at the point you are most relaxed (i.e. your canoe trip), I try and preempt this by taking some big breaths or thinking of an adrenaline situation when I think I may be vulnernable. I love rock/blues music and would certainly think twice before going to see Fleetwood Mac!!

    Also I understand most triggers (e.g. putting head in cold water) can start and stop it if you are "vagally mediated" (I believe the term is). However I haven't tested this as no AF for 19 months.

  • This question comes up on this forum from time to time.

    My husband's AF was the direct result of post traumatic stress disorder. I have absolutely no doubt in my mind that massive dress was the cause. Having dealt with the stress, his AF is dormant. He has postponed an ablation for the time being.

    The truth is that everyone is different. Stress may well be the cause for some but not for others. Large doses of adrenalin affect the heart, more so as we get older.

    My daughter in law has had short episodes of AF during her pregnancy. According to the midwife, having a massive extension built onto the house, being pregnant and looking after a toddler all at the same time has absolutely nothing to do with it.

  • Interesting! There is often no telling as everyone is different. I did not have any attacks during my pregnancy, but fearsome after miscarriages.

    We certainly are certainly individuals, but, there is room for helping one another also. Blessings,

  • Drs do not have the personal 'experience' of the suffering!

    Anything can set this off - & the lack of sleep also. but, there may not even be any particular thing --

    It can happen through too much exertion -- but later when relaxed after it.

    You know your own body. but do not be too upset about any contradicting opinion of Drs. They cannot know every individual's effects of this on the system.

    I believe its a bit like epilepsy, being electrical. so, some of it is a mystery.

    Also, any agitation in the heart related to attacks can prevent sleep - adding to the dilemma! We do have to practice relaxing as much as possible, but I would not recommend - New Age type, after living in an Eastern Society.

  • Undoubtedly there is a connection which is recognized by most EPs. My own experience is that AF anxiety is very different to ordinary anxiety and I say this as a therapist who worked with people suffering from anxiety and depression for 20 years.

    I have written about this on other posts and it is quite involved but if I can summarize:-

    My own experience was that many AF episodes had pre cursors which I can only describe as an adrenaline rush. This is something I had never experienced before or have since. I don't believe this had a psychological nor an emotional link and came at times of stress and when I had no stress. I am not a worrier and am very experienced at delivering and practicing CBT - made no difference other than help me deal with it so that I didn't worry about it, just observe the symptoms and record them.

    May I suggest you research the sympathetic / parasympathetic nervous system, which includes the vagal nerve, then take your research back to your doctor and ask how it cannot be connected.

    If you are a worrier then I suspect you will suffer even more from anxiety as it will in effect rack up the physical symptoms.

    By the way I had to have 2 ablations, as many do many, for elimination of AF, one is sometimes not enough.

  • Your anxieties were not the cause, but could trigger the AF.


  • PS - have you undergone a sleep study? I have sleep apnea and had very disturbed sleep with AF. My EP referred me for a sleep study - I was treated with CPAP which I still use, if there one thing that improved my QOL it was that as I now sleep a straight 6-7 hours every night. My doctor told me that latest research has shown that as well as lifestyle factors, the biggest link between people going back into AF after successful ablation was sleep apnea.

  • I wholeheartedly agree with you .

    I have endured AF since 1992 and directly link it to stress ( my career didn't help ).

    I have mentioned this to various Doctors over the years. Most were non committal.

    Anyway I had an ablation carried out here in Plymouth on 29th November.

    The procedure went well but was marred by a major bleed I had from my bladder which finally stopped after two days.

    Very scary as I take Apixaban.

    Discharged 3 days later and now at home feeling reasonable under the circumstances.

    To conclude there is no doubt in my mind whatsoever that in my case stress is coupled with AF.

    I only hope in spite of that the AF doesn't return.

    Currently having the occasional " flutter " which I am told is perfectly normal and should decrease and hopefully disappear altogether over the coming months.

  • Trouble is that most doctors think on a mechanistic cause and effect level so unless there is 'proof' from a peer approved research study they will always be non commital.

    The body is a complex system of systems with complexities we are only just recognizing throughout the fractal levels. Talk to an expert in complex systems and they would tell you that everything is connected to everything else but it is not as simple as straightforward cause and effect.

  • Rest plenty and learn relaxation - do anything that brings a smile - best medicine!

    I am now so sensitive to stress I have a reaction (not AF related) within seconds so I cannot allow myself to become stressed without unwanted consequences.

    Go well.

  • Thanks Cdreamer for your expertise really appreciate your replys

  • Sometimes makes you want to crawl into bed with a book. Very hard to stay away from any stress...we live in a world full of it both positive and negative.

  • My subconscious brain/mind and my AF are directly linked. For starters, if you have an arrhythmia and your heart is not beating properly, then you'd got to be brain-dead not to be concerned about it underneath, even if on the surface you have a stiff upper lip and say to yourself you are not bothered. I have some anti-anxiety pills which I take if I have a bad attack, and they have worked on both occasions I have taken them, proving the point to me that my subconscious mind, natural reaction, fight or flight, whatever you want to call it, was in control.

    I'm sure that if you can calm your life down, get good sleep and reduce stress then this has to be good. I've also found that it's actually little stresses, or even annoyances, that bother me more than big stresses, like buying a house etc. A perfect example, and this will sound real silly, is being stuck at the end of a row in a crowded cinema watching a dreadful film. One such film bought my AF on for 3 days, as every other word began with "F" and I hate serious swearing. So, when we go to the cinema, it's end row seats or nothing and we walk out if we don't like the film. Another would be traffic. If I had to commute through traffic I'd go crazy, thankfully the only traffic I have to cope with out here in the sticks are queues of sheep.

    I've also cut out all alcohol, most caffeine which have both helped and also eat regularly but in small amounts as large/or even normal sized, meals will set me off.

    For me, it also helps to know your triggers, but without dwelling on them. Fir example, if you know that you get AF after a large meal, then when it happens you can just wait for it to dissipate without it being a worry.


  • We must be twins because all you say is what I experience too!! Two weeks ago whilst watching a play at the theatre which was so badly performed I could feel an episode starting so we had to leave in the interval. I just so up tight about things these days and that is definitely one of my triggers!!

  • If you can get a handle on the part(s) of you that react to the "little stresses, or even annoyances," and learn to be non-reactive when they hit, you can make a big difference in your experience of stress.

  • Most of the above are good and valid responses. You have a predisposition to AF which may be genetic or acquired so stress can be a trigger. Changing your mindset, diet and general life style can have a massive affect on how much AF you get. A diet of mainly plant based food, no alcohol, mindfullness to reduce stress etc can apparently all help reduce quite drastically the number of events which you suffer. As has been suggested, a sleep study to check for sleep apnoea would be useful as this is known to be contributory. Your GP knows little about AF. See a specialist such as an elctrophysiologist (EP).


  • Its a vicious circle stress/anxiety can cause stomach problems which in turn can cause an irregular heart rate.

    Read all you can about the vagal nerve and about the conditions that can effect it you don't have to be a medical genius to link it back to your condition, when you have that knowledge go back to your GP and discuss the way forward.

    Your heart's structure is such for whatever reason(excercise/hereditary) that you are susceptible to AF however, you can with patience reduce attacks and who knows may be even stop them altogether.

    The vagal nerve is know as the super highway of the body I have found a lot not all gastroenterologists know much more about AF because of the involvement vagal nerve than GP's or cardiologists.

    Stress/Anxiety = AF Stress/Anxiety = Stomach Problems = AF

  • I don't think that anxiety triggered my AF initially but it certainly fed it, once I had a diagnosis 6 years later. In those six years of having funny turns I wasn't too concerned as repeated visits to my GP showed everything was normal so I just tried to ignore them.

    Once I was diagnosed, though, I started to worry about my heart and wait for the next bout to start - even though I tried everything I could to remain calm.

    The other posters have given good advice - I hope you find a calming solution. I'm trying Yoga at the moment.

  • I agree, I suffer from both,

  • I too suffered a lot of stress and anxiety (due to bereavements ) and am still in the same position after I was off work for the biggest part of last year .I was then diagnosed with A fib

    The year off work (due to Afib and treatment options) caused so many financial problems which I am struggling to address (and stressed again ) but fortunately I have a great EP and we have the attacks under control otherwise the debt stress would start it again. A vicious cycle and I have no family to support me financially .

    Meditation eases the situation. Lavender oil and most of all keep busy and enjoy each day

  • I believe there is definitely a link, but not necessarily a direct cause and effect.

    I have suffered with palpitations at times of stress right from my teens. I had endless tests over the years and was always told my heart was very healthy. I was always ill with rolling palpitations during and after dentists appointments, until adrenaline was removed from injections and then I was perfectly fine. I was told to avoid caffeine and other stimulants years ago. About ten years ago I had awful palpitations linked to my digestion, which were cured with medication for acid reflux. If I stop the medication the palpitations re start after a couple of weeks.

    In March 2013 I left my job after 6 months off with stress, but no palpitations. Due to financial difficulties my husband and I sold our property in England to buy a much less expensive, but larger property in a beautiful coastal area of southern Island. The move was very complicated and stressful, with us not actually officially owning the property until 2 months after we moved in. One week after we officially owned the property I started with Afib. Since then I have episodes brought on by various precursors, including on one occasion most definitely emotion. I am still told that my heart and vessels are all very healthy. I have been a vegetarian for 20 years, swim a mile a week and walk daily, but am obese. I was having episodes of Afib every 3 to 4 months, each one lasting longer, with the last one lasting 3 weeks. I am of course on blood pressure mess, beta blockers and anti coagulants.

    I am a spiritual person who began meditating some years ago, but have done much reading on enlightenment and buddist beliefs and have joined a group on practical philosophy. I now meditate twice daily, live as mindfully as I am able and have found a path of peace and love. I know this sounds corny, but I really do feel 'at peace'. I have had no Afib for 6 months so far and am hoping that I will experience it less frequently or maybe it may not return. Our hearts and minds are linked and emotions affect our whole bodies, including our hearts so I cannot see how a link between Afib and stress can be denied, but that doesn't mean everyone with stress gets a fib or that afib is only caused by stress. We are all finely tuned by both our genetic make up and our experiences so are all unique individuals. I hope you find this lengthy response helpful and I wish you well for the future.

  • Interesting - I also react to adrenaline and cannot have anaesthesia without complications because of another condition. Nothing like something like that to change you reliance on others curing you!

    We are our own healers, just we have forgotten it because we have relied on instant gratification from our culture and health service for so long.

    I completely agree with your outlook and also find that the digestive system is our best barometer of our wholistic health, keep that healthy along with regular exercise and a positive outlook doing anything and everything which gives you joy.

    Blessings and best wishes and I cannot believe you could ever be corny!

  • Yes, definitely. How much this can be managed by natural means - breathing , meditation, relaxation techniques I'm trying to discover, whilst in a bad patch of extremely fast irregular heartbeats, which the normal medecine Verapamil is not controlling. Being outdoors & concentrating on eg birds landscape feeling in harmony out alone in somewhere beautiful I find helps me to manage it. Symptoms do not disappear, but I can live with it better. Good Luck!

  • Anxiety and stress can absolutely worsen AF in a person who has the AF substrate. Back at diagnosis the first the my EP did was schedule appointments for me to learn relaxation and meditation techniques, as well as an exercise coach. Not sleeping, not handling stress, not exercising, not eating right will worsen AF for those of us at risk because we have the substrate. For people who don't have it, those same factors may cause or aggravate other illnesses...that's why they are called DIS-Eases. Managing all those factors pre and post ablation does increase the odds that it will be successful. Wishing you NSR and stress relief. Mindfulness, meditation, yoga all work wonders.

  • My doctor and consultant both told me that due to my increased heart rate and af, adrenalin is pumped into my body which means I have a flight or fight reflex - or in plain old terms I'm anxious. So yes, physical symptoms can create other physical symptoms which we then think are in our heads but they are just that, physical symptoms. By all means use mindfulness or any other calming/coping strategy you find helps but for me, the confirmation that my increased anxiety had a physical reason helped me to deal with it really well. Now I can recognise that the anxiety I often feel is enhanced by the adrenalin and it helps me to manage how I feel. The upside is that I am good at meeting deadlines and being on time!

    There is a massive danger that those on the outside feel that your anxiety is being caused by having the condition -eg worrying about it. I really could not care a less about my heart problem so I did wonder why I felt so much more anxious. Now I know and I can deal with it. I've had three ablations, I will never be 'cured' and I still get af episodes but I also have a demanding full time job so I manage it.

    Incidentally - although it has to be a good thing to manage depression and anxiety this did make me laugh when I found it on face book - sometimes we just do need medication to get better, the same as for any illness although there are a lot of people out there who are all too keen to condemn it. It really is up to the individual.

  • i could not agree with you more but depression is a separate diagnosis and we were talking about event triggered anxiety - big difference.

    Of course it is always an individual choice as to whether or not to take medications and if it eases your pain and allows you to function, of course you should take it, I certainly have. I hope just because we express a view it does NOT mean we condemn another view. We are all unique - there never has been a you with your genetic make up, your life experience and there never will be another you.

    I would also suggest that there Is always a risk/benefit when taking any meds and the risks and side effects of anti-depressants include increasing anxiety and suicidal thoughts in some people which have sadly led to suicide. Now they may have done it anyway, but the increase in anxiety is a well documented for some of the Serotonine uptake drugs.

    Therefore my choice would always be to work with both lifestyle and use medications only when I can see that the benefit to me would be greater than the associated risks.

    I find it Interesting that all medications could give you the symptoms that you take the meds for.

    'I may not agree with your views but would always fight for your right to express them'.

    You express very well the opposite polarity to Isobel and those who chose to give up a stressful, demanding job and I hope it works for you.

    Best wishes CD.

  • Stress will exacerbate AF it is unlikely to be the cause. Predisposition to the condition may arise through genetics/lifestyle.

    My AF arose during a game of squash. I was a keen and played around 3 times a week. I was ablated. It was a success but not a cure. I am on a PIP regime now.

    I am aware that I get irregularities if I am tired, eat too much, drink too much and when I am anxious/stressed. One needs to minimise the triggers by amending lifestyle. Eat moderately, exercise regularly and learn to moderate the stress. This is difficult if one gets anxious due to an atrial episode!

    You did not say how long it has been since your ablation. It is usual to get problems post op for at least 3 months after but my EP said it could be up to a year.

    GP's are not specialists, speak to your EP if you want advice. A second ablation may be required.

  • Well I tend to think there is a connection. I did not have any Af until 3 years ago. Since then my life has been like living on the Jeremy Kyle show and I get most symptoms when I am especially stressed.

    I have kept a record to prove this to myself,so there must be some link. I'm not saying there isnt a physical problem as well, just that I think it is excaberated by stress.

    Please no one say go to yoga, would love to but work long hours,mad shifts and classes are few a nd far between.

    You take care andgold x

  • you bet it does, I had a stress full job 10 years ago never slept for week but i was really tiered i lay in bed and my heart kept going fast and slowing down, never heard of afib then, then 10 years later was diognosed with afib, the doctor said ive had it for years as my left aitrium was enlarged. i know that job done me, well you live and learn

  • Hi

    I totally agree with you on stress being a cause of afib. I first started with afib after a period of ongoing stress and my doctor at the time was looking for another cause and wouldn't accept my theory that stress had been the major cause. My consultant in Blackpool was more receptive and agreed with me. Keep going with the ablations as it took three to make me symtom free and please realise that your doctor probably knows less than you do about afib than you do. One day it will be accepted that stress is a major cause of afib in those of us who have a predisposition to the condition of that I am totally certain. Chin up and keep smiling

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