I have a question about stress, both mental and physical and what role people think it plays in af. I already know a fair amount about af but I would like the opinions of fellow sufferers as I think this is the most accurate as opposed to doctors.
I am under a fair amount of stress lately and my heart has decided to play up again, after having been quiet for a while following an ablation. Very frustrating.
Look forward to hearing from you all and thanks for reading.
Written by
AorticOracle
To view profiles and participate in discussions please or .
Interesting question but perhaps one should substitute "stress" with adrenaline. My point being that we all need some stress to function. Distress is what does the damage.
Throughout my long and extremely full life I have had long periods of high stress which seldom caused me any problems but the thing I always found was that when that stress ended was when I was ill. My dual life in banking and motorsport usually resulted in serious collapse around November after the season was over and the adrenaline faded from my system.
We also know that adrenaline is bad for AFwhich is why we should always ask our dentist for adrenaline free local anaesthetics.
I suppose the bottom line is it is not so much the stress but how we each process it that is the problem. Like most things really.
Hi Bob. Thanks for the speedy reply. I used to process stress fairly well. Now I’m incredibly susceptible to it. Im still not convinced either way if my af is a symptom or cause of my lack of stress tolerance. It’s almost impossible to say either way in my view.
Good advice Bob re adrenaline free anaesthetics at dentist. I never thought about that. Definitely possible trigger for me.
Good Morning AorticOracle,
Periods of stress can overwhelm the body, which in turn releases chemicals preparing your body for a ‘fight or flight’ response, even when it is not necessary. If you are a person who experiences stress on a daily basis, this can have a big impact on your body and physical health.
You may like to take a look at our booklet on 'Mindfulness and Healthy Living with AF' for tips on reducing stress : api.heartrhythmalliance.org...
Our Patient Services Team are also here if you would like to talk with one of us, by phone 01789 867 502 or email info@afa.org.uk
Thank you for the information Katrina. I think we all experience stress on a daily basis but like Bob said above it’s more down to how our mind and body process it. As you can see from my profile picture meditation is a big part of my life and does work wonders but since my heart issues, I’m finding stress increasingly hard to deal with as it arises and as time goes by. I used to swallow it whole and ask for more but now it’s challenging to deal with and my heart soon lets me know when it’s had enough.
Totally agree with Bob (which is unusual 😉).
As I mentioned in fibnums post earlier, stress and anxiety affects me more than anything else but unfortunately, it seems that as you get older and more unwise, the more difficult it becomes to manage stress. I always try to take my own medicine when one of my old colleagues was climbing the walls I said, whatever you are worried about now, you’re unlikely even remember what it was about in a month or two. Doesn’t always work though…………
Totally agree flapjack. As I said above it’s getting more and more challenging as time passes. Whether this is a symptom or cause of af is a tricky question to answer but one I would love to figure out.
For me,absolutely convinced that sustained stress either aggravated undiagnosed AF( I put down palpitations as just stress responses for ages) or caused it.Even now,stress can provoke it ,after a successful ablation and a year of nsr,I had an emotional incident and it raised its head again. Several since so am now on rf list for top up.
Definitely The factor for me,despite my best efforts to control the stress levels.
An interesting post and an interesting reply from BobD above.. I think that you are right that both physical and mental stress can induce or exacerbate AF.The effect of physical stress is perhaps easier to understand, when you are young you can push yourself to your limit, run a marathon etc. When you are older walking briskly up an incline may all that is needed to induce a similar response. Cardiac distress after a period of sustained physical stress is not particularly surprising. I think that the effects of mental stress can be more subtle and elusive. I think that both mental and physical stress are equally important and trying to separate the 2 can be futile.
In healthcare holistic treatment and care is a phrase which is often mentioned in literature and is advocated as being essential for good practice. I used to think that this is at odds with the fact that medicine is essentially reductionist in nature.There are specialities and subspecialities. Many of the great medical advances that we have witnessed can be attributed to this reductionist approach. Perhaps one drawback is that each speciality becomes more introspective. Holism can be lost in the process. Ithink that dualistic thinking is still reasonably common.
I looked into this a number of years ago (pre Afib). The literature seemed to say that the central nervous system the immune system and endocrinal system are the essential actors in the interplay between mind and body. The ideal outcome is homeostasis.
Moving on from this philisophical digression, I think that I can relate some of this to my own personal experience of Afib. I found that health anxiety could quickly bring on or worsen my Afib. The CNS response/fightt or flight alerts the endocrinal system, adrenaline raises the heart rate etc. A stream of worrying thoughts can accelerate the process. A recent episode of Afib was concurrent with a week of Covid. I guess my immune system was under stress.
I have found that a healthy lifestyle, good nutrition, moderate exercise, deep breathing, mindfulness and yoga have all been very helpful.
Mental stress/worry always affect my heart - even though my AF is controlled with Flecainide.
The strange thing is that during the 'acute' stage of a stressful situation, my heart is fine, strong and working well. When that stage is dealt with and some normality returns I get ectopics for days and sometimes several weeks every evening for hours at a time. Probably Flecainide stops it from becoming AF.
For me, diversion helps to calm things down, especially if the diversion is complicated and needs concentration. Definitely a case of mind over matter.
hello finvola. Thanks for the interesting comments. I think that may be something to do with the adrenaline Bob was talking about earlier. When your body no longer requires it and it therefore leaves then maybe this is what’s kicking the af into gear? I can’t say that this happens for me personally. My heart seems to struggle during the stress but I will pay closer attention from now on and see if this is the case with me too.
That would make sense Aortic - using adrenaline to cope, then suffering its consequences when the peak subsides. Oddly enough, this is the first evening in several weeks that I haven't had a single ectopic . . .
STress most definitely has a b ig effect on me. 2 months ago I was taken into hospital for 4 days with a very bad arrhythmia which was most definitely triggered by stress. It turned out not to be AF but my heart was doing a tango. My last episode was 11 months ago - I had another 24 hours last week when my stress levels went through the roof
It’s hard once it takes hold. Very hard to shake. Meditation helps me but it all depends on what’s causing the stress. Once the spiral has started it starts to eat away at everything and then before you know it the heart is showing its unhappiness too.
I’m sure, from experience, that it does, but most answers are focusing on emotional stress so I will point out that emotional stress can cause high BP which may not be picked up if it is temporary but is known to affect AF. Some people like me find that anxiety affects their digestive system which can also be involved in generating AF if only because of dehydration. Then there is the effect of high heat or cold on the body. I go into AF almost to the moment the temperature rises above a certain point! Pushing exercise whether leisure or work beyond the body’s capacity is another factor, straining the circulatory system and/or causing inflammation.
I could go on but I think we’re pretty much agreed that physical and mental stress are interlinked and any one of those but often a combination generate AF In susceptible people.
They are certainly interlinked as is the entire body. It’s such a complicated vessel it’s almost an impossible job to keep it running smoothly. I’m like you and stress goes straight to my stomach which then causes more carnage throughout my body. Then the cycle continues until my heart is paying the price. The heart is like a pressure valve for the body and when it goes it takes everything with it.
Stress plays a huge role in my opinion. Like you’ve said further down it’s hard to tell which one is feeding into which. I would also love to be able to answer that question but I think it may be a bit of both. A never ending cycle that’s hard to break. We just have to try and do our best to mitigate it as much as possible. Each person has their own strategy’s. I will continue to follow this post with interest to see what others feel and how they cope with it . Good luck 👍
Interesting study published in the Journal of American Heart shows one in 4 post menopausal women are likely to develop arrhythmias and these show a significant link to stressful life events and insomnia:
Very interesting article, just what me and my cardiologist were discussing last week, article could almost be written for my circumstances.... thanks for posting.
No doubt we are all stressful people and may be why we are in this predicament or at least one of the reasons. People generate and deal with stress in different ways as well so may not even notice it happening. I find it a very interesting topic either way.
I would say a definite yes. Physical stressors can also make an AF episode more likely. Virus infections certainly can, as the immune response is inflammatory and will increase the heart rate, amongst other things. Alcohol stresses the body because it has to do the work of eliminating it. It’s not always emotional stress, but physical stressors too.
Learning stress management techniques is beneficial both physically and mentally, and if you can establish a daily habit of practicing a method that suits you, then you will benefit in many ways. There’s no one true way, it’s whatever works for you that you can stick with. There are breathing exercises, relaxation, meditation, mindfulness and even apps. It doesn’t matter what it is, as long as you can find something and stick to it. Easier said than done, I know, but it’s value comes from daily practice over the long term.
Good Morning, From my experience stress both physical and mental can worsen and precipitate AF.Roger
B4 Covid I was very fit, swimming,gym work, table tennis, walking, country dancing. In lockdown on my own, I decided it was a good time to study for a qualification via distance learning. I had the support of an online tutor throughout but it was quite challenging. I feel the combination of isolation, the lack of human contact, especially within a social context, much reduced physical exercise, and the challenge of studying and completing all the modules became very stressful and, guess what? AFib arrived. Since then I’ve had two cardioversions but have relapsed into AFib twice - when I moved house and a year later when I had the whole outside of the home insulated with 6” thick insulation - 6 men, scaffolding, banging for six weeks! 666 - the sign of the devil AFib!
I went into fast AF at about 1am this morning and still going strong at 7.30am. I have stress on a daily basis looking after my husband with Parkinson's. Yesterday started off well but ended badly. I know that I shall have to attend A&E where I shall most probably be electrically cardioverted. I will hold on for a few hours. I waited 2 days in June before I presented at A&E and was given a ticking off for leaving it so long. I then had my 25th dccv a few hours later.
I agree totally with BobD and will have to remember distress as opposed to stress as that is me too. I too have had long periods of high stress but as I coped well and not aware of it really affecting me I didn’t acknowledge it. What I did notice was when I went on holiday you could guarantee by about the 2nd or 3rd day I was shattered, tired, achy, under the weather etc it gradually wore off and by the end of the holiday I could have run a marathon or climbed mountains. It took me ages to put two and two together.
Im 70 and have been retired 10 years now but still when I go on holiday the same kind of thing happens. Another difference is how I react to stressful situations since retirement or at least getting older.
I had that “pressure cooker syndrome” for years without knowing what was going on …. Great under pressure and when I stepped for a break I became ill with colds, coughs, tachycardia,bradycardia, non specific ached and pains…
Nowadays it’s much better as I can choose who I move with ( most of the time! ) and therefore manage my reactions
I’m rather new too and my Afib is 100% correlated with stress. I recently traveled to see family and had an episode both before and after the flight. Usually I have 1 per month and always after a monthly meeting I run (and enjoy). I even got AFib after a contentious card game with a granddaughter! I never go into Afib during the stress; always that night at 12 or 1. Until I got an Apple Watch I never knew it was happening- slept right through. Imo 10 mg propanolol shortens the duration but most medical ppl say that can’t be.
I think beta blockers can help stop an AF episode, even though the general consensus is that they don’t. In any case, the high HR in AF isn’t a good thing and bringing down the rate in my mind makes it more likely to go back into NSR. I have an Apple Watch too, but I’d caveat it by saying that it comes up with “possible AF” when there’s actually a lot of ectopics going on, so it helps to learn to read the tracing rather than rely on the watch’s conclusion.
Normal stress is good as it releases Adrenaline for a short while! Constant fight or flight stress, pouring Adrenaline into your system could and can do eventually lead to exhaustion and burn-out! But every person is different and so are circumstances either with your home life, work - pressure to perform, traveling from A to B, financial strains or risking poverty!
All in all can affect your health in the long run!
Unhealthy diets 🍔
excessive smoking 🚬
excessive drinking alcohol 🍻🥂
and lack of exercises, like working out at home or Gym or in a Group, walking, biking, jogging, swimming, rambling, even belonging to a choir, singing, has it's benefits, belonging to a local brassband,different sports like football, rugby, netball, tennis etc
If you love playing an instrument that can really relax you to calm down and make you feel at ease!
I have experienced many stressful situations and periods of constant stress! It did affect me mentally with bouts of depression and probably smoking too much whilst at work because of stress being understaffed at times! Well heart attack 2019 was the result as it finally caught up on me!
All I can say:
Don't worry about tomorrow, live one day at a time!
Constant fretting and worrying about everything what wrong etc your Adrenaline will shoot up!
We all have energy concerns and how to pay for it,
Concerns about rents and mortgage payments, fuel for our cars, and food to live on!
When I go shopping I buy what I need, not what I want!
It's a learning curve but we have to master this!
So try and breathe deeply in and out, like the judge Anton told Angela, Breathe 💃🕺 don't hold your breath!
And do what you can do in your own circumstances, don't try to be someone else, or Superwoman or Superman, RIGHT 👌😁
Yes stress is one of the strings in my bow. The others are alcohol, too much caffeine and over eating in a hurry. All those things cause stress in different ways to your body. Best thing I ever did was read Breath by James Nestor as suggested by one of the good people on this Forum
Yep, breathing, taking a breather is important! Otherwise it's like a Merry-go-round, sleep, eat, caffeine to stay awake or combat lack of sleep, work, smoke or drink, back to bed 👌 sometimes socialise! Been there, done that, worn the t-shirt 👍Well in Germany we say:
"The jug goes so long to the well until it breaks!"
For me it was my sudden midnight heart attack 👌
That book you mentioned sounds interesting Oz 👌🥰 I shall have a look at that 👍😁
Years of a very stressful occupation in an allegedly dream occupation - wine - led to me leaving my job in an ambulance never to return.
Life without air miles, corporate events, customer meetings and negotiations and the super competitive/ ambitious and sly is so much sweeter I wish the ambulance had arrived sooner - years sooner!
My PAF has subsided to a minimal level and only rears its head when I have to deal with the occasional bonehead or unpleasant event eg: a family death. I work occasionally as a carer and as a film extra both of which I enjoy better that any of the jobs I had ( apart from 3 years running an operation in Spain)
AF exists as part of the family history but most with it lived to reasonably old age 84, 89, 92 and so on apart from Uncle Tony who was in his allotment lean to when an ash tree collapsed on it during a high wind.
He’d only just been diagnosed with persistent AF and had taken it very badly, we never got to hear his views on the arboreal maintenance at the allotment - I’m sure the stress of that would have kicked off an episode of AF ! Under the allotment rules I now have the allotment as I was working it with him and we’ve put in place a tree care programme. I digress.
Anyway, I’m on minimal meds, edoxaban and a statin , healthy diet, no caffeine and no wine and plenty of exercise as I want to be really fit when I die.
Yes, my stress ( distress) if it didn’t cause my AF it certainly exacerbated it and my GP and consultant support that view.
Some really good posts here.Stress definitely a huge risk factor for me, including emotional (e.g a loved one with a terminal illness), an argument, physical (e.g working long hours without taking appropriate breaks for eating or drinking water) and overdoing excercise.
The only thing I would add is that there are 2 stress hormones. Cortisol is released first, which gets the body ready for the Fight or Flight response e.g. our ancestors spotting the lion in the distance. If that lion runs at you then adrenaline is released so that you can try and run away or up the nearest tree to get away from the danger of being eaten.
One thing to remember is that Cortisol remains circulating in your body for hours even after the lion has gone from your sight. The reason for this is that the lion could still be lurking in the long grass stalking you, so your body needs to be prepared to run or fight off the lion again.
In our modern lives the primitive part of the brain still exists, and can over react to harmless threats (you feel your heart pounding if you know you have to get up in front of a group of people to give a speech). So even if you calm yourself down (breathing slowly and deeply taking your mind off things) that Cortisol is still circulating for a few hours ready to release the adrenaline.
I used to be on Diltiazem as a rate control drug. My doctor swapped me to Bisoprolol as I am more prone to stress. I'm not a Dr so it's not for me to give advice on meds, but I believe that Bisoprolol works on the heart as it competes for the same sites in the heart as Adrenaline. Discuss this with your Dr for proper clarification.
After my STEMI + cardiac arrest in July 21 left me firstly in continuous AFib ( for 3 months), now with bits of PAF, NSVT, SVT I developed generalised anxiety. I spoke with my EP about treatment for which I was already going to counselling for and we decided on medication. Sertraline. He said anxiety doesn’t cause the arrhythmia’s, it’s tha damage to the heart muscle for me, but anxiety aggravates the arrhythmia’s I already have. Which experience of the arrhythmias makes me agree with him.
My worst bouts of AFib have occurred at times of emotional stress. Physical stress is something I am used to as I lift weights 3 x a week and although one could argue that it puts strain on the heart my recovery time is quick and I have not noticed it bringing on an episode.
Stress is the No 1 cause ..that's what my Cardiologist said. It generates inflammation in heart vessels ... in fact she said STRESS is a killer! You have to find a way to stop it by Psychologist via Hospital and your Dr. Talking Therapies is excellent they give you work to do to manage it ..it works. It's free. In the UK. I was told the stress I had on and off in my life.plays a huge part in the damage that comes to your heart. Find a way to stop it for your heart to recover and stop the inflammation.
not too long ago I had one of the most stressful events in my life. It lasted a good 2 weeks. Not just bouts of stress but it was 24/7. I really did think it would bring an episode on. I also thought alcohol might be unwise too but during this time I did have a few drinks (I’m more or less tea total these days) I’m happy to say, neither brought in an episode.
I now believe my episodes are brought on with sugar. I only think this as my last 2 episodes came on almost immediately after eating sweets. Again, not something I do a lot of but they were bought for me.
I’ve had echocardiograms that show my heart is in perfect working order (for now 🤞🤞) I don’t have high cholesterol nor do I have high blood pressure which both can bring on afib I believe. My conclusion for me is it’s good content related. I think we all have different triggers.
Stress is a very major factor in my experience. In fact, I think that the fact that I worked 30 years in an amazingly stressful job in teaching plus playing a major role in local politics in my 'spare time' until late at night several times a week, is what gave me AF in the first place. I now find that any stressful experience even in being a 'keyboard warrior' on the computer can tip me over into AF (that I can feel happening) and I have to do relaxation exercises. My AF is permanent but normally well controlled by a beta blocker, but any real stress overwhelms even the drug.
For me there's stress and stress. I can cope with a holiday in Sicily where I'm doing all the driving. No problem even when a reckless driver coming from the opposite direction overtakes and I have to jam on the brakes and swerve off the road. Cool as a cucumber. But I can't watch any kind of film where they rachet up the tension with spooky music. Also had to switch off the telly at the Euros mens final last time when I knew a penalty shoot out was coming.
Hello there! This is the first time I’ve posted. I was under a horrendous amount of stress for over 2 years with my mother in law who had severe dementia and then my 54 year old brother who battled a rare cancer for 13 months and then died back in January. Myself and my elderly mother were my brothers main carers. My MIL then passed away in March of this year. I started to notice strange palpitations in October 2022 when my brother was told he was terminally ill. My Fitbit picked up some rhythm abnormalities and after 2 heart monitors and some more Fitbit data I was diagnosed with paroxysmal AF in May and immediately started on Edoxaban and then bisoprolol a few months back. My cardiologist said it quite possible that the stress induced my AF. I have episodes about every 1-2 months but with modifications to my lifestyle and the reduced stress in my life I am managing well so far.
I definitely feel that stress caused my AF. I was working in a busy 2 week wait oncology department at the hospital and there were 3 of us but 2 went off sick at the same time for several weeks. I was given some simple help but the stress of trying to keep up with everything and make appointments within 2 weeks of referral plus all the data logging took its toll. When things calmed down slightly in that the staff came back, I began to get AF episodes. The referrals kept increasing week on week and more appointments had to be scheduled together with diagnostics either before or on the same day as the consultant appointment. The managers were never that pro active and relied on us to tell them when nothing was available and would then take things right to the wire before setting up extra clinics. The onus was then on us to contact all the patients sometimes for an appointment the same day as their breach date which put an awful lot of stress on us to fill the clinics. The AF episodes became more frequent and I had to have the next day off after being up all night and then loads of tests to try to find a cause for the AF, eventually resulting in work saying I had to be monitored by HR because I had had too many episodes of sickness/time off for medical tests in a 3 month period. I couldn't believe it - I worked for a hospital yet it wanted to penalise me for time off caused by too much work pressure! So much for a caring organisation. Eventually they decided they could report my sickness in a different manner so it wouldn't trigger HR monitoring, more staff were taken on and my AF episodes became less frequent and more manageable with medication. When I retired, the episodes dropped right back but unfortunately, with age, they became ever more frequent over time becoming weekly as different stresses took over. Happily, I can now say that 10 weeks following ablation, apart from the day after ablation, I have been AF free. So yes, stress is a major cause of AF. Good luck
It's good to really understand what the definition of Stress is as people often mistake it as only a negative thing.Stress can be caused by both , Positive or Negative. physical or mental , and either good and fun or bad and sad activity. We feel Stress when we do something which is more than our body or mind can cope with at its current health level.
So it's just as possible to feel the effects of Stress while on holiday , at a family event or having fun with our friends as it is trying to reach a deadline at work or during a family crisis.
This also makes it more understandable that we tolerate any type of Stress less well after an illness or injury, if we have a chronic health condition , or as we age.
Most chronic health conditions can make it harder to cope with Stress because of the toll they take on our general health , but the symptoms of those conditions are also triggered or made worse by the impact of Stress so it becomes like a vicious circle.
That's why it's really important to find ways to pace your daily activity to help manage the Stress we experience and reduce its impact.
Adjusting the way we do activities and planning our week to allow a good balance of activity and rest is a good way of doing this.
Previous generations used to say , " Don't burn the candle at both ends", and they were right.
These days we can get into the habit of not just trying to burn the candle at both ends but in the middle too and this eventually plays a big toll on our bodies ability to cope and our long term health.
It's good to find a " New Normal" that helps you to control stress in your day to day life whilst maintaining a good quality of life.
Often taking a few minutes each hour in the working day to stretch , or sit and breath with eyes closed helps your body to sustain calmness and makes you less tired and more productive, as does taking a proper lunch and having a little stroll outdoors after eating and getting away from your desk during breaks .
It's also good to give yourself a cut off time for working when you go home and sticking to it.
This is also a good strategy with using social media or texting too.
If we have a lot of work to do or are very busy doing jobs on our home or planning an event it's also helpful not to plan to cram lots of social activities into our evenings as well, but to use that time to do relaxing activities, gentle exercise or any interests that help us to switch down a few years whilst we have the chance.
Making sure we have a good bedtime and sleep routine also helps to restore the body and mind and make it easier to cope with the Stress of a new day.
In my case, stress absolutely is an a-fib trigger. If I can just remember to breathe slowly and mentally transport myself out of the current situation, it would work wonders!
Boy BobD explains things well. When I'm stressed it's a wonderful thing especially with family and friends. we're obviously not talking bad stress with worry or anxiety but enjoyable stress bringing hopefully the best of who we are out. BUT, when accompanied with exhaustion or lack of sleep or both and an extra drink (for me s total of 3 to 4 max) it can trigger AF with me especially in the night when I get up or get up faster than normal. That's usually the root of my trigger and I'm much more cautious now and aware of this connection.
Hello, what katrina-admin says is spot on. I was just told by an Emergency Room Dr. in regards to my afib to "stop worrying so much and enjoy life", easier said than done but I know she was right as she was very knowledgeable on afib, treatments, what it does to our atria and ventricles as to what happens when we're in afib and medicines which work best for afib. She asked what I knew about afib and I told her I know it won't kill me. Bottom line is stress and WORRY is BAD NEWS for people with afib, or for anybody for that matter as it will eventually take it's toll on us. Wishing You GOOD LUCK on your afib journey. Have a Blessed Day.
Good morning everyone here 🌅I happened to wake up today at 3 am in the morning, but glad I did 👌🧠
Well started watching BBC 1 Night News Channel and here is a brilliant
Short Documentary from
Melissa Hogenboom, a Science Journalist about "3 Brain Brainhacks to improve our mental, cognitive, motor dexterity, neurological disorders, brain injuries, and lots more!"
I am so glad I watched this and hope Aortic and anybody else will take time to watch this on BBC 🥰
Wherever you live in the UK take care in these coming days, especially in Scotland 🙏🥰
For me, when I was in paroxysmal AF, then both mental stress and physical tiredness seemed to be big factors in provoking episodes of AF. The third major factor was alcohol. If I drank a lot of an evening, then I seemed much more likely to get an AF episode in the night or the following day
thanks again everyone for your comments. Lots of great information and all in one place for myself and anyone who needs to find it. Thanks again everyone for their contributions!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.