Anxiety and heart palpitations
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Anxiety and Heart Palpitations: Understanding the Connection
Introduction to Anxiety and Heart Palpitations
Heart palpitations, characterized by an awareness of the heartbeat, can manifest as a strong, skipping, fluttering, racing, pounding, thudding, or jumping sensation in the chest. These sensations are often benign, caused by premature atrial or ventricular beats, or stress-induced sinus tachycardia. However, they can lead to significant anxiety and other psychological symptoms 26.
Prevalence and Impact of Palpitations in Women
Palpitations are particularly common in women and can cause disturbing symptoms, including anxiety, depression, and decreased health-related quality of life (HRQOL) 157. Studies have shown that a significant proportion of women experiencing palpitations report high levels of anxiety and depression, which can exacerbate the perception and severity of palpitations 15.
Psychological Factors and Palpitations
Anxiety is a common cause of palpitations, with up to a third of cases attributed to psychological factors 2. Research indicates that women with palpitations often have higher scores on anxiety and depression scales, suggesting a strong link between psychological distress and the experience of palpitations 357. Additionally, heart-focused anxiety, where individuals are overly concerned about their heart health, can lead to increased medical service use and significant behavioral impairment 8.
Mechanisms Linking Anxiety and Palpitations
The autonomic nervous system plays a crucial role in the relationship between anxiety and palpitations. Reduced heart rate variability (HRV) and cardiac vagal tone are often observed in individuals with panic disorder, a condition marked by frequent palpitations 4. This reduction in HRV is consistent with the cardiac symptoms experienced during panic attacks and highlights the autonomic underpinnings of anxiety-related palpitations 4.
Digital Interventions and Their Efficacy
Recent studies have explored the use of digital techniques, such as handheld electrocardiogram (ECG) devices, to provide instant feedback on heart rhythm during palpitations. These devices, connected to smartphones, offer immediate analysis and response, which has been shown to reduce symptoms, anxiety, and depression, and improve HRQOL in women 15. The Coala Heart Monitor, for example, has demonstrated significant reductions in anxiety and depression scores and improvements in HRQOL after two months of use 15.
Conclusion
Heart palpitations, while often benign, can significantly impact psychological well-being, particularly in women. Anxiety is both a common cause and a consequence of palpitations, creating a cycle of distress. Understanding the autonomic mechanisms and utilizing digital interventions for real-time feedback can help manage symptoms and improve quality of life. Addressing both the psychological and physiological aspects of palpitations is crucial for effective treatment and management.
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Most relevant research papers on this topic
2202Instant analysis of the ECG with a new digital technique during palpitations reduce symptoms, anxiety, depression, and increase HRQOL in women
Instant ECG analysis during palpitations reduces symptoms, anxiety, depression, and improves overall health-related quality of life in women.
Observational Study
Rigorous JournalAssessment of palpitations
Most palpitations are benign, but some may be caused by heart rhythm abnormalities or arrhythmias, and psychological factors can contribute to their severity.
Rigorous JournalIndependent association of palpitation with vasomotor symptoms and anxiety in middle-aged women
Palpitation in middle-aged women is associated with vasomotor symptoms and anxiety, rather than age, menopause, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption.
Observational Study
Very Rigorous JournalAutonomic balance revisited: panic anxiety and heart rate variability.
Reduced heart rate variability and cardiac vagal tone are associated with panic disorder, suggesting a need for a systems perspective on autonomic balance.
Highly CitedInstant electrocardiogram feedback with a new digital technique reduces symptoms caused by palpitations and increases health-related quality of life (the RedHeart study).
Instant ECG feedback during palpitations reduces symptoms, anxiety, and depression, and improves health-related quality of life in women.
Observational StudyAnxiety and hot flashes as predictors of mid-life palpitations: getting to the heart of the matter in the time of COVID-19
Anxiety and hot flashes are significant predictors of mid-life palpitations in Japanese women, with anxiety being a key factor in their risk.
Very Rigorous JournalP6574Symptomatic palpitations causing anxiety in women, what are the underlying arrhythmias
Most symptomatic palpitations in women are benign, but in 5% previously undiagnosed atrial fibrillation or supraventricular tachycardia are found.
Observational StudyRigorous JournalHeart-focused anxiety, illness beliefs, and behavioral impairment: Comparing healthy heart-anxious patients with cardiac and surgical inpatients
Healthy heart-anxious patients experience similar fear of chest pain and heart palpitations as cardiac and surgical inpatients, and exhibit higher levels of cardiac disease conviction, awareness, and protective behaviors compared to surgical patients and nonpatients.
Observational StudyHighly CitedThe Fundamental Basis of Palpitations: A Neurocardiology Approach
Palpitations are a pathway from the heart to the brain, influenced by cardioception awareness, body size, fat percentage, and psychological conditions.
Literature ReviewContinuous event recorders did not affect anxiety or quality of life in patients with palpitations.
Continuous event recorders do not negatively impact anxiety or quality of life in patients with palpitations, and may lead to better outcomes due to less cardiac diagnosis and more emphasis on psychological well-being.
RCT
Large Human Trial