Anxiety, Arrhythmia, and Medication: the Connection

Anxiety, arrhythmia, and medication issues?

Hello, Director.
I have a history of anxiety disorder and, with my doctor's consent, stopped my medication about a year ago.
Recently, I seem to be experiencing signs of a relapse, and I have also noticed an increase in the frequency of palpitations.
After an electrocardiogram, my doctor indicated that I have arrhythmia and prescribed antiarrhythmic medication for me.
I would like to ask if there is a connection between anxiety and arrhythmia, or does the presence of arrhythmia on the electrocardiogram indicate a heart problem? Additionally, my psychiatrist has suggested that I undergo autonomic nervous system testing.
Should I stop taking the medication before the test? I have read some articles suggesting that antiarrhythmic medication should not be stopped casually, but I am concerned that this might prevent the detection of the aforementioned issues.
Thank you for your response, and I wish you peace.

Miss He, 30~39 year old female. Ask Date: 2023/11/28

Dr. He Dongjin reply Cardiology

Hello, anxiety during seasonal changes can lead to autonomic nervous system instability, resulting in increased palpitations.
Anxiety and arrhythmias are related; however, arrhythmias do not necessarily indicate a heart problem.
Regarding autonomic nervous system testing, I believe it is not essential to have a definitive diagnosis.
Whether or not you undergo this testing shouldn't cause you distress about stopping medication, as that could lead to increased anxiety.
It's important not to stop antiarrhythmic medication abruptly, but it's not that serious.
Previously, you were able to stop for a while without issues.
Just relax! If the frequency of palpitations increases, you can take your medication regularly to help reduce the frequency of palpitations, and then gradually taper off as needed.
Changhua Hospital cares about you.

Reply Date: 2023/11/28

More Info

Anxiety and arrhythmia are indeed interconnected, and understanding this relationship is crucial for managing both conditions effectively. Anxiety can manifest in various physical symptoms, including palpitations and irregular heartbeats, which are often perceived as arrhythmias. This connection arises because anxiety triggers the body's fight-or-flight response, leading to increased adrenaline levels. This surge in adrenaline can cause the heart to beat faster and may result in feelings of palpitations or irregular heart rhythms.

When it comes to your situation, it is essential to recognize that while anxiety can contribute to the sensation of arrhythmia, the presence of arrhythmia on an electrocardiogram (ECG) does not necessarily indicate a structural heart problem. Many individuals experience benign arrhythmias, which may not require invasive interventions. However, it is crucial to follow your healthcare provider's recommendations, as they can assess the severity and implications of your specific arrhythmia.

Regarding your concern about medication and autonomic nervous system testing, it is generally advisable to consult with your healthcare provider about whether to continue or discontinue any medications before such tests. Some medications can influence heart rate and rhythm, potentially affecting test results. However, abruptly stopping medication, especially those for arrhythmia, can lead to worsening symptoms or complications. Therefore, it is vital to have an open discussion with your doctor about the best course of action.

In terms of managing anxiety, it is essential to consider both pharmacological and non-pharmacological approaches. Cognitive-behavioral therapy (CBT) is an effective treatment for anxiety disorders and can help you develop coping strategies to manage anxiety symptoms without solely relying on medication. Additionally, lifestyle modifications such as regular exercise, mindfulness practices, and adequate sleep can significantly impact anxiety levels and overall well-being.

If you are experiencing a resurgence of anxiety symptoms, it may be beneficial to revisit your mental health provider. They can assess your current situation and determine whether a reintroduction of medication or a change in your treatment plan is necessary. It is also important to monitor your symptoms closely and communicate any changes to your healthcare team.

In summary, anxiety and arrhythmia are linked, and managing both conditions requires a comprehensive approach. Consult your healthcare provider regarding medication management, especially before diagnostic tests. Consider integrating therapeutic strategies to address anxiety while maintaining open communication with your healthcare team to ensure optimal care for both your mental and physical health.

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