Mindfulness meditation of benefit to heart attack survivors

Practising mindfulness meditation helps reduce fear of activity and improve quality of life in patients who have survived a myocardial infarction (MI), according to a study presented at the ESC Acute CardioVascular Care (ACVC) 2021 Meeting.

One of the reasons why survivors of MI suffer from low quality of life is a fear of movement, or kinesiophobia, said presenting author Dr Canan Karadas of Hacettepe University, Ankara, Turkey. “Fear of movement limits daily activity due to concerns of another heart attack.”

“Our study shows that mindfulness can reduce fear of movement and improve quality of life in heart attack survivors, with effects extending beyond the completion of the intervention,” she said.

The study involved 56 patients (mean age 55 years) who had survived an MI. They were randomized 1:1 to undergo mindfulness meditation or control intervention for 8 weeks. The meditation group underwent 15 minutes of meditation sessions daily comprising sitting and breathing exercise, while the control group received a single 15-minute individual education session on heart structure, function, and related health. [ACVC 2021, abstract 20343]

“Mindfulness refers to the mental state achieved by focusing awareness on the present moment, including thoughts, feelings, and physical sensations,” explained Karadas. “It has drawn increasing attention for treating chronic conditions such as high blood pressure. Our study examined its effect on fatigue, kinesiophobia, and quality of life after an acute MI.”

By week 4, the meditation group showed less fear of movement, as reflected on the Tampa Scale for Kinesiophobia Heart questionnaire, compared with the control group (mean score, 36.18 vs 41.89; p=0.001).

This benefit persisted through weeks 8 and 12, with significant decrease in fear of movement among participants who practised meditation across the two time points (mean score, 34.39 vs 41.82 for week 8 and 34.96 vs 41.00 for week 12). 

In accordance, participants in the meditation group saw better improvement in quality of life, as indicated by MacNew Heart Disease Health-Related Quality of Life questionnaire. The overall difference between the two groups was significant at week 8 (mean score, 5.76 vs 5.37; p=0.005).

Specifically, the MacNew Quality of Life questionnaire assessed how three aspects of life — physical, emotional, and social — have been affected by the MI incidence, as perceived by the patients. Improvement in the emotional function continued to be significant up to week 12 of follow-up (p<0.05).   

Measures of fatigue, as assessed using the Piper Fatigue Scale, were comparable between the two groups across all time points.

“Our study shows that mindfulness can reduce fear of movement and improve quality of life in heart attack survivors, with effects extending beyond the completion of the intervention,” said Karadas.

“One explanation may be that meditation replaces catastrophic thinking with positive thoughts, making patients feel less emotionally and physically vulnerable. The findings suggest that mindfulness may be considered in the rehabilitation of patients after a heart attack,” she added. “These results are very encouraging but more studies are needed to confirm our findings.”