Stress induced atrial fibrillation was long recognized by patients. But can stress cause atrial fibrillation? Recently, both physical and mental stress have been identified as independent causative factors. Learn both the doctor's as well as the patient's take on the matter.
What is Atrial Fibrillation
Atrial fibrillation is an irregular heartbeat or a rapid heartbeat or a quivering of the upper chambers of the heart. It is due to a malfunction in the heart's electrical system and is the most common heart irregularity or cardiac arrhythmia. The risk of atrial fibrillation increases significantly after the age of 50 years. It is more common in men than women. Many a time, it occurs without any obvious warning signs. But, if they do occur, the symptoms include:
1. An uneven pulse
2. A racing or pounding heart
3. A feeling that the heart is fluttering
4. Chest pain
Can Stress Cause Atrial Fibrillation - A Patient's Perspective
Atrial fibrillation can occur in otherwise healthy persons when they are stressed or fatigued. Most patients when asked what triggered it mentioned stress as being a major risk factor. It has been suggested that stress causes a rise in blood pressure which provokes atrial fibrillation. Atrial fibrillation disappears with avoidance of stress. Caffeine and alcohol are also known to be a trigger which can be explained as we consume them in excess when under stress. In a study, a full 50% of respondents listed emotional or work related stress as a triggering factor. Emotional stress was found to trigger atrial fibrillation in 26% of cases whereas physical overexertion was found to be the aggravating factor in 24% of cases. Other triggers suggested are food, hot baths and weather changes but stress has been found to be a universal trigger among all respondents.
Stress Induced Atrial Fibrillation - A Doctor's Perspective
Atrial fibrillation which occurs in absence of any underling heart disease is known as primary or lone atrial fibrillation. It may be an isolated event or it may recur on an intermittent basis. It is rarely chronic. It is significantly more common in men than women. An attack may last a few hours or days, but rarely longer than a week. The frequency of attacks may occur less than one a year to three or more per year. Excessive physical or emotional stress is considered to be one of the factors responsible for this phenomenon. Stress induced atrial fibrillation is believed to be due to sympathetic overactivation. The other causative factors are considered to be alcohol, hyperthyroidism and certain foods like chocolate and coffee. Because there are many types and triggers for lone atrial fibrillation, its treatment and prevention can be extremely difficult.
The heart usually returns to its normal rhythm on is own. But treatment may be needed if troubling symptoms occur. In people older than 75, doctors recommend treating lone atrial fibrillation to reduce the risk of stroke.
These are recent views of doctors on atrial fibrillation. Irrespective of this, the popular view is that stress is not an important factor in atrial fibrillation. Atrial fibrillation is believed to be majorly caused due to a physical defect in the heart. Doctors believe that atrial fibrillation occurring solely due to stress is a very rare phenomenon. Very severe stress like the death of a family member which affects the body and mind profoundly may trigger atrial fibrillation but as such stress is not believed to have an important role in atrial fibrillation unlike high blood pressure which is believed to be directly related to high stress levels.
To conclude, stress induced atrial fibrillation is now recognized as a separate entity by doctors unlike previously when it was considered as idiopathic. Though patients have since long identified stress induced atrial fibrillation as a separate entity, it has gained medical recognition and importance since recently. But the popular view is still that stress does not have an important role in atrial fibrillation in the absence of a physical defect.
1. Atrial fibrillation by John Rawles, 1992.
2. The ESC textbook of cardiovascular medicine by A. John Camm, Thomas F Luscher, P.W Serruys, 2006.