Anxiety sensitivity (AS) is the fear of bodily sensations associated with anxiety.1 Sweaty palms,
shallow breathing, rapid pulse and other symptoms accompanying stress can be perceived as
relatively benign or as warnings of impending doom. People with higher AS tend to overinterpret
and catastrophize in response to such symptoms. AS is a relatively constant personality
factor. It is distinct from anxiety itself, which fluctuates with events.2 Most research on AS has
focussed on panic disorder.3 Panic disorder patients have higher scores than normal individuals
on AS measures, and people with higher AS are more likely to have panic attacks.4
We
previously reported that coronary artery disease patients who experience panic attacks provoked
by CO2 inhalation show significantly greater reversible myocardial perfusion defects than those
who do not panic,5 suggesting that AS might be associated with prognosis.
In atrial fibrillation (AF) patients, AS has been explored as a cross-sectional correlate of
lower quality of life and greater symptom severity and preoccupation.6 Indeed, individuals with
higher AS are more 7 but the potential
prognostic importance of AS has not been explored. In the Atrial Fibrillation and Congestive
Heart Failure (AF-CHF) trial,8 patients with AF and CHF responded to the Anxiety Sensitivity
Inventory (ASI)9 before randomization to rate- versus rhythm-control strategies. They were
followed for at least two years. Because individuals with higher AS tend to be more preoccupied
with AF symptoms, we explored whether the psychological/physiological correlates of AF,
and/or treatments influencing it, might also vary with AS.