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Anxiety Sensitivity Influences Cardiac Treatment Approach

New research suggests consideration of an individual’s anxiety sensitivity is an important factor when choosing medical treatment for some heart disorders.

Specifically, Montreal Heart Institute researchers believe levels of anxiety sensitivity may be important in formatting a plan of care for patients with heart failure and atrial fibrillation (AF).

Heart and Stroke Foundation researcher and lead author Nancy Frasure-Smith, PhD explained that anxiety sensitivity is the degree to which a person is frightened by bodily sensations and symptoms, particularly those associated with anxiety.

“For most people, sweaty palms and an increasing heart rate are simply unpleasant symptoms that occur in stressful situations; for others these same symptoms are interpreted as a sign of impending doom,” says Dr. Frasure-Smith.

“People with high anxiety sensitivity tend to magnify the potential consequences of their anxiety symptoms, leading to an increase in anxiety and its symptoms in a spiralling increase of fear and worry.”

While anxiety sensitivity is known to predict the occurrence of panic attacks in cardiac and noncardiac patients, and is associated with greater symptom preoccupation and worse quality of life in patients with AF, it has not been previously studied as a predictor of cardiac outcomes.

These results are based on a sub-study from the Atrial Fibrillation and Congestive Heart Failure Trial (AF-CHF), a randomized trial of rhythm versus rate control treatment strategies whose results were presented at the Canadian Cardiovascular Congress in 2008.

Prior to randomization 933 AF-CHF study participants completed a paper and pencil measure of anxiety sensitivity. They were then randomly placed in one of two treatment groups: a ‘rhythm’ group that was treated with antiarrhythmic medication and cardioversion (an electric shock to convert an abnormal heart rhythm back to normal rhythm); and a ‘rate’ group that received medication to help keep people’s heart rates within a certain range.

Participants were followed for an average of 37 months. Results showed that, as in the overall AF-CHF trial, the majority of patients had as good a prognosis with the rate control strategy as with the rhythm control approach.

In contrast, patients with high anxiety sensitivity had significantly better outcomes if they were treated with the more complicated rhythm control strategy.

“Increased emotional responses to AF symptoms in people with high anxiety sensitivity may lead to increased levels of stress hormones making them more vulnerable to fatal arrhythmias and worsening heart failure,” says Dr. Frasure-Smith.

“For AF-CHF patients with high anxiety sensitivity maintenance of normal sinus rhythm appears to be important.”

AF is a common type of heart arrhythmia which affects approximately a quarter of a million Canadians, including up to forty percent of individuals with congestive heart failure.

During AF the upper chamber of the heart (the atria) beats irregularly and very rapidly. Patients may experience palpitations, shortness of breath or chest pain. While by itself AF is usually not fatal, it increases the chances of heart failure and stroke.

When AF and heart failure occur together, there is an increased risk of fatal outcomes, so finding the best treatment for each patient is extremely important.

“While the study − a sub analysis of a larger trial – is not definitive in itself, it does raise interesting questions,” says Heart and Stroke Foundation spokesperson Dr. Beth Abramson.

“We tend to underestimate the power of the mind in patients on powerful heart medications. Mental wellbeing, however, is an important aspect of care for all heart patients.”

Source: Heart and Stroke Foundation of Canada

Anxiety Sensitivity Influences Cardiac Treatment Approach

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2016). Anxiety Sensitivity Influences Cardiac Treatment Approach. Psych Central. Retrieved on May 21, 2018, from https://psychcentral.com/news/2010/10/27/anxiety-sensitivity-influences-cardiac-treatment-approach/20199.html

 

Scientifically Reviewed
Last updated: 7 Jul 2016
Last reviewed: By John M. Grohol, Psy.D. on 7 Jul 2016
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