Recently seen arrhythmia in medical practice is, atrial fibrillation (AF). Nowadays, several reports have been made based on anxiety in AF individuals. The purpose of this review is to (1) describe the incidence of anxiety having AF by studying related literature, (2) examines the effect of anxiety on persons which are having AF,(3) give such evidences that show hypothetical relationship among pathophysiology of AF and anxiety, (4) assess the advantage of AF on anxiety treatment, (5) and provide imminent in patients having AF and associated anxiety. This review concluded that there is a multifaceted relationship between AF and anxiety. AF can source anxiety in the patients, and anxiety can generate a situation that is favorable for the instigation and prolongation of AF. Significantly, anxiety affects how the patients recognize their ailment, mainly for women, and influence the healthcare application. The incidence of anxiety may affect the efficiency of various AF therapies. Hence, executing strategies that may decrease anxiety in AF patients can recover treatment consequences, patients HRQOL, and lessen financial problems related to AF.
Key words:Atrial Fibrillation; Anxiety; Cardiovascular disease; Treatment; Epidemiology
1. Introduction
The most serious cardiovascular epidemic that affect about more than three million people in US (Chapa, Thomas, Friesmann, & Akintade 2015) is Atrial fibrillation (AF). Few risk factors which enhance the prevalence rate of AF are, diabetes, male gender,
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congestive heart failue, obesity, hypertention and aging of population [1, 2]. Morbidity and mortality rate is significantly related with AF. Now, most of the studies have been conducted in order to assess the AF impact on health related quality of life (HRQOL) [3]. Though, a very little studies have been reported about AF patients with anxiety. The purpose of this review is to (1) describe the incidence of anxiety having AF by studying related literature, (2) examines the effect of anxiety on persons which are having AF,(3) give such evidences that show hypothetical relationship among pathophysiology of AF and anxiety, (4) assess the advantage of AF on anxiety treatment, (5) and provide imminent in patients having AF and associated anxiety. 2. Methods A comprehensive literature search (studies published during 2001 to December 2015) was made from Embase, EconLit, Google Scholar, Medline, PubMed, ProQuest, Scopus, Springer Link and Science Direct databases. “Atrial Fibrillation”, “Anxiety”, “Cardiovascular disease”, “ Treatment” and “Epidemiology” were used as keywords in diverse combinations with BOOLEAN and MeSH search. Further publications were recognized by a manual search of references of related papers, and review articles were also cited where applicable. 3. Results and discussion Initially, 213 studies were retrieved. Out of these, 62 were duplicates and therefore were excluded. Out of 151 remaining articles, 70 were dropped off based on irrelevant title and/or abstract. Subsequently, full text of 81 articles were read and 48 studies were further removed as these failed to provide relevant details. Finally, 33 articles were selected for this review. 3.1. Epidemiology of Anxiety in AF Patients Various reports that analyzing the anxiety among cardiac patients now been carried out in coronary heart disorder patients[2]. Thought, the person having AF only, supposed to be found with increased rate of psychological distress. Thrall et al. reported that about 28% and 38% of patients having AF were supposed to have state and trait anxiety according to State Trait Anxiety Inventory (STAI).Whereas, the height of trait anxiety was significantly higher compared to those patients that have any other chronic disorder assessed at study, hypertension, (38% amongAF patients vs. 22% among hypertensive patients, 푃= 0.03). Height of anxiety is associated with quality of life among AF patients. Quality of life is found to be poor among female and unwaged patients. Furthermore, levels of anxiety among AF patients was not significantly changed after the six months of follow up [4]. Satisfaction rate among AF patients were found to be significalntly less related to their work, activities, social as well as sex life and spare time just because of this disease limitations[5, 6]. Dabrowski et al. indicated that female having AF predominantly face depression, physical signs and sleep problems as compared to males [5]. Ong et al. reported that low quality of life is found among females patients having AF compared to male[7]. Frasure-Smith et al. indicated inAF-CHF trial of rate versus rhythm control strategiesthat anxiety is the cause of prolonged cardiovascular mortality among AF patients and heart failure[8]. Perret-Guillaume et al. reported that physical manifestations of AF are found to have less clinical consequence than psychological. In order to provide evidences, data have been gathered from elderly populations through Duke Health Profile which gave major discrepancy in mental function and anxiety in patients with AF compared to control.On the contrary, the similarimplementbring into being no statistically major differences in measures of physical health, social impairment, or disability [9]. Similarly, Arisnsen et al. evaluate an elderly population (>75 years, 푛 = 27) and found no significant high prevalence rate of anxiety among AF patients by using HADS(Health, Anxiety and Depression Scale). Consequently, it was noted that physical manifestations held accountable for diminishing the quality of life in AF patients by having SF-36. However, the dissimilarity in finding could be accredited to the actuality that Ariansen et al, select only those patients having lasting and clinically constant AF[10]. 3.2.
The Association between the Pathophysiology of AF and Anxiety
Various studies have indicated that individual with AF have on enhanced risk of anxiety because of low quality of life. Although, either anxiety initiates AF still not been investigated comprehensively. Now, from Eaker et al. it is clear that anxiety is one of the cause of AF in both male and females above ten year of time period [11]. The information about whether anxiety trigger AF is very
limited. It is supposed that inflammation and oxidative stress are the main cause of perpetuation and stimulation of AF [12]. Patients with anxiety have enhanced levels of acute phase reactants i.e. C-reactive proteins, proinflammatory cytokines, and decreased levels of anti-inflammatory molecules [13]. In one of the report of Rommel et al. indicated that in unadjusted investigation, mild-to-moderate and severeanxiety were linked with more hs-CRP contrast to no orminimal anxiety in a population having AF [14]. Son and Song indicated that their is increased risk of hs-CRP levels in AF patients having “Type D” personality compared to those with non-type-D personality [15]. Pervious studies reported that enhanced level of CRP is related with prevalence of AF [16, 17].Significantly, the finding of Son and Song and Tully et al. does not broadly found that anxiety initiate new AF as these finding were found in those patients who previously have AF[15, 18]. Moreover, anxiety patients are more likely to have sympathetic nervous system [19]. Hansson et al. finding suggested that catecholamine release due to the psychic stress, which is the provocative factor among paroxysmal AF patients. Although this study is only based on the patients views about what initiate AF in them while no psychologic instruments are being used[20]. After cardiac surgery, anxiety manifestations enhanced the risk of AF, reported by Tully et al. Main symptoms of anxiety,enlarged sympathetic tone and lessend vagal tone , have been renowned earlier to postoperativeAF, prior to the beginning of atrial flutter andthe inception of lone AF [18].
Heart disease is one of the most common causes of the mortality and morbidity in most well developed countries. They come in different forms such as stroke and other cardiovascular diseases and it’s the number one cause of death in the state of America. In the year 2011 alone nearly 787,000 people were killed as a result of this epidemic. And this included Hispanic, Africans, whites and Americans. As for the Asian Americans or pacific Islanders, American Indians and the natives of Alaska, the concept to them was a second only to cancer. However, statistics has proved that a person gets heart attack every 34 seconds and in every 60 seconds, someone dies out of it which include other related event. Additionally, majority of the women are the
Even over the short course of my clinical experience thus far, various consultants have asked my colleagues and I about the pathophysiology of AF, the causes of AF and most have been asked to describe the rhythm of the pulse of AF. Hospital doctors do not have to look far to find a patient with the often symptom less disorder, and quiz medical students on it. A study conducted in Trinity College, Dublin by Finucane et al (2011) reported that 10.8% of Irish men over the age of 80 are living with AF2. They also reported prevalence across all age groups of 3.2%. AF is highly prevalent in Ireland today, and is set to become more prevalent in the country, in keeping with our agei...
2. By looking through the case study, the most prominent problem Sara struggles with, is her persistent worry about different parts of her life including her job status, health and her relationship with her husband. For the past six months, she has been anxious and worried excessively, leading her to have difficulty sleeping. As she admitted, “ I cannot shut my brain off anymore, I am worrying all the time”, therefore her condition met the primary criteria of generalized anxiety disorder which is the excessive worry for at least 6 months more days than not, about diverse events and activities. Being restless, irritable, having sleep difficulty and being easily fatigued are four factors of GAD that are apparent in this case. “I have always had lots of energy but now at times I struggle to get out of bed and drag myself thorough the work day”; it indicates the fatigue she recently experienced. Fidgets with her jewellery when speaking and a nervous laugh she has, shows her persistent anxiety. Moreover, she was recently diagnosed with irritable bowel syndrome which has a high comorbidity with anxiety disorders. In conclusion, since she is persistently worried about different aspects of her life and she has the criteria for GAD, generalized anxiety disorder is the most likable disorder she has.
As mentioned earlier, Atrial Fibrillation is one of the most common cardiac dysrhythmias in the world. It is easily treatment and managed as long as the patient follows the advice of medical professionals. The exact cause and triggers of atrial fibrillation are unknown and are still being researched today. Through patient education, medication regimen, healthy diet, understanding your condition, and being conscious of your emotional health are crucial when it comes to the management of atrial fibrillation.
The BAI consists of 21 descriptive statements of anxiety symptoms. The test taker indicates how often the symptoms have occurred within the last week. The scoring sheet has four columns which are rated on a 4-point scale with the following correspondence: Not at all = 0, Mildly = 1, Moderately = 2, Severely = 3. The test taker marks the appropriate colum...
Cardiovascular disease is currently the leading cause of death in the United States. It is responsible for one in four deaths every year, about 600,000 mortalities. This disease affects men and women, as well as every ethnic group. Coronary artery disease is the most common cardiovascular disease, representing approximately 400,000 deaths per year of the aforementioned 600,000 total deaths from cardiovascular diseases as a whole. In 2010 alone, coronary artery disease cost the United States $108.9 billion for health care services, medication, and lost productivity. These chilling statistics, published every year by the American Medical Association, demonstrate the immediate need for new and innovative ways to prevent, detect, and treat coronary heart disease. This paper will explore the molecular biology behind the disease while explaining the current treatments and prevention that are available today, why they work and what can be done to improve them.
... anxiety and it is not a negatively-adapted trait, but rather an instinct that can sometimes seem primitive in such an advanced culture. Reading this article did not provide me with any new approaches to dealing with my anxiety, but the statistic about the disorder’s prevalence on page 56 helped me to feel less alone. Before reading Park’s article, I had never really considered the possibility that anxiety could have positive results or an evolutionary basis intended to improve the chances of survival. For those with anxiety looking for alternative methods of alleviating those feelings or a deeper understanding of the sources of their anxiety, this article may prove a valuable read. People who do not have anxiety themselves could also benefit from reading this article, as it provides an accurate snapshot of the struggles a person suffering from anxiety experiences.
The onset of Generalized anxiety disorder begins in childhood or adolescents, and It can have a lifetime prevalence of 3-5% with a higher risk in women. One major effect of Generalized Anxiety Disorder is excessive worry or anxiety lasting up to 6 months at a time, although individuals that have Generalized Anxiety Disorder don’t identify their worrying as excessive all of the time, but they will recount subjective distress because of a constant worry, or may have difficulty with control over the worrying, or even experience social impairment. Anxiety can be associated up to 6 symptoms which include inability to sleep, fatigued, lack of concentration, easily agitated, muscle tension, and sleep disturbances. Most of which can affect everyday lifestyle and greatly effect physical health, not only can they cause personal distress but may also cause distress in those around.
Since 1960 the age-adjusted mortality rates for cardiovascular disease (CVD) has declined steadily in the U.S. due to multiple factors, but still remains one of the primary causes of morbidity and premature mortality worldwide. Greater control of risk factors and improved treatments for cardiovascular disease has significantly contributed to this decline (Centers for Disease Control and Prevention, 2011). In the U.S. alone it claims approximately 830,000 each year and accounts for 1/6 of all deaths under the age of 65 (Weiss and Lonnquist, 2011). Based on the 2007 mortality rate data an average of 1 death every 37 seconds is due to cardiovascular disease (Lloyd-Jones et al., 2009). Controlling and reducing risk factors is crucial for saving lives. There are a number of contributing risk factors for cardiovascular disease, which may appear in the form of hereditary, behavioral, and psychological, all of which ultimately converge in social or cultural factors.
Today, cardiovascular disease is “the number one killer in the United States and the developed world” (Sapolsky, 2004, p. 41). Coronary heart disease (CHD) is the most common form of cardiovascular disease, and is responsible for claiming an unreasonable amount of lives every year. CHD can begin to accumulate in young adults, but is prominently found in both men and women in their later adult lives. As a result of CHD, men typically experience heart attacks, whereas women present with chest pains, known as angina (Matthews, 2005).
Along with being the most widespread mental health disorder, women are more likely to be affected by most anxiety disorders than men. Anxiety disorders are often characterized by feelings of worry, uncertainty, anxiety, or fear, which can be so intense, it can interfere with a person’s daily activities. Therefore, it is likely for a person struggling with an anxiety disorder will find themselves unemployed, financially dependent on others and even have poor quality social relationships as well. As an anxiety disorder may affect other functional impairments, it is also important to be aware of its development considering an anxiety response affects various populations and individuals differently.
One of the leading causes of death in the United States is heart disease. “Approximately every 29 seconds one American will have a heart attack, and once a minute one American will die from a heart attack” (Ford-Martin and Odle, 915). According to the Gale Encyclopedia of Alternative Medicine men over the age of 45 and women over the age of 55 are considered at risk for heart disease. Heart disease is a major cause of death. It is beneficial to individuals who seek to prevent heart disease to recognize the risks leading to heart attacks as they are one of the primary indications of developing heart disease; especially those that fall into the at risk age groups. These risks consist of some that cannot be changed such as heredity risks, or those that can change such as smoking habits. It is very important to know these specific risks for prevention and to understand the symptoms of heart attacks, such as sweating or the feeling of weakness so if these or other symptoms occur people are aware. Finally heart disease treatment is of vital importance if you experience a heart attack so you can learn how to prevent another one from occurring.
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National Institute of Mental Health. (2009). Studying anxiety disorders. NIH Medline plus, 5, 13-15. Retrieved from http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml