The Association of Perceived Stress and Atrial Fibrillation

Higher perceived stress links to more AF and related symptoms.Independent risk factors include male sex, diabetes, dyslipidemia, cardiomyopathy, and stress; need longitudinal studies to clarify causality.

Atrial fibrillation (AF) is the most prevalent persistent arrhythmia and imposes a substantial burden on public health and society. Given prior evidence linking psychological factors with AF, this study was conducted to investigate the association between perceived stress and arrhythmia.

In this case-control study, participants were recruited from the Outpatient Clinic of Rajaie Cardiovascular, Medical, and Research Center in Tehran, Iran, between May 2021 and September 2021 according to eligibility criteria. Data were collected through face-to-face interviews by trained research nurses using standardized checklists. Stress levels were assessed with the Perceived Stress Scale (PSS). Data were analyzed with SPSS, version 22.

A total of 155 cases with arrhythmia and 144 controls were enrolled. In the case group, the mean age was 53.99 years (±14.23), with 100 males (64.5%) and 55 females (35.5%). In the control group, the mean age was 48.53 years (±13.59), with 73 males (50.7%) and 71 females (49.3%). The mean perceived stress score was 30.6 in cases and 25.07 in controls (P<0.001). Stress-related symptoms, including palpitation and chest discomfort, were more common in patients with arrhythmia than in healthy controls (P=0.015 and P<0.001, respectively). In multivariate logistic regression analysis, the risk of arrhythmia was independently associated with sex, diabetes mellitus, dyslipidemia, cardiomyopathy, concentration difficulty, chest discomfort, and stress score.

The findings demonstrate that AF is significantly associated with psychological stress and higher perceived stress scores. Interventions aimed at reducing stress in individuals at high risk of developing AF may be beneficial.