Parasympathetic attenuation

Atrial fibrillation (AF), the most common cardiac arrhythmia links to significant morbidity, mortality, and healthcare costs through typical risks like ageing, hypertension, and structural heart disease. Recent studies show chronic psychosocial stress, negative emotions, and mental health factors in AF susceptibility. This review integrates AF epidemiology, focusing on mental stress and adverse emotional states interacts with atrial electrophysiology. Key mechanisms include sympathetic upregulation, parasympathetic attenuation, HPA axis overdrive, inflammation, and myocardial remodelling. Observational data associate persistent stress with higher AF incidence yet causation and stress reduction effectiveness remain uncertain. Targeting modifiable psychosocial factors mat contribute to improve risk stratification management and quality of life.