Stress as a Reversible Risk Factor in Atrial Fibrillation Management

By Jonathan Springston, Editor, Relias Media

There appears to be a “bidirectional relationship” between atrial fibrillation and stress, and possibly alleviating the latter could lead to better management of the former, according to the authors a paper published online this week.

Investigators reviewed current literature about atrial fibrillation and modifiable lifestyle habits, what they called “the fourth pillar” of atrial fibrillation management. In addition to eating a healthier diet, limiting alcohol consumption, and exercising more, there also is chronic stress, which is a recognized bad actor in heart health. However, the authors explained how this relationship “is poorly defined.”

In their literature review, the researchers observed how as stress rises, patients can develop poor lifestyle habits to cope (e.g., smoking cigarettes, drinking more alcohol, eating bad food). In turn, those bad habits can lead to all kinds of poor heart health outcomes, including atrial fibrillation.

“Recognizing stress as a potentially modifiable risk factor in these patients builds on a more holistic approach to AFib management,” Peter Kistler, MBBS, PhD, senior study author, said in a statement. “As such, targeted stress reduction may improve symptom perception and outcomes for patients with AFib.”

Kistler and colleagues acknowledged more precise research is needed to create standardized definitions and measurements of stress, but they suggested clinicians could recommend integrative solutions (e.g., yoga, mindfulness meditation) or additional medications (e.g., antidepressants) to help their patients better manage atrial fibrillation.

For more on this and related subjects, be sure to read the latest issues of Clinical Cardiology Alert and Integrative Medicine Alert.