Mindfulness linked to better psychological health a year or longer after cardiac arrest

Cardiac arrest survivors who are more mindful, or aware of the present in a nonjudgmental way, reported fewer symptoms of depression, anxiety and post-traumatic stress disorder than survivors who are less mindful, according to preliminary research to be presented at the American Heart Association's Resuscitation Science Symposium (ReSS) 2021.

Cardiac arrest, an abrupt loss of heart function, often is fatal if cardiac pulmonary resuscitation (CPR) and defibrillator shocks are not delivered within minutes to restore normal heart rhythm. More people are surviving cardiac arrest thanks, in part, to better awareness and training among the lay public and health care professions to recognize and quickly treat people who experience an arrest.

"Although survival rates have improved, the physical, cognitive and psychological effects of surviving cardiac arrest may linger for years, signaling the need for both immediate and long-term care for survivors," said study author Alex Presciutti, M.A., M.S.C.S., a Ph.D. candidate at the University of Colorado in Denver.

"We conducted this study to examine potential ways to prevent and treat psychological symptoms, such as post-traumatic stress disorder, depression and anxiety, among cardiac arrest survivors," Presciutti said. "We focused on how mindfulness, defined as non-judgmental awareness of the present moment, may be related to psychological symptoms in long-term, cardiac arrest survivors."

The researchers studied 129 people (average age of 52 years; 52% male; 98% white individuals) who had survived cardiac arrest an average of five years and were members of the Sudden Cardiac Arrest Foundation's online support group. Those in the study completed two mental health surveys, a baseline in 2019 and at one-year follow-up in 2020. At the beginning of the study, all study participants completed the PTSD Checklist-5, which gauges for post-traumatic stress disorder, and Patient Health Questionnaire-4, which assesses for depression and anxiety. At the one-year mark, the surviving study participants completed the Cognitive and Affective Mindfulness Scale Revised assessment, which measures attention, awareness, acceptance and present focus.

The study found:

• At one-year follow-up, practicing more mindfulness was moderately associated with fewer psychological symptoms, such as posttraumatic stress, depression and anxiety. In other words, on average, survivors experienced fewer psychological symptoms when they practiced more mindfulness.
• Baseline psychological symptoms moderately predicted the psychological symptoms at the one-year mark, meaning the more psychological symptoms survivors experienced at the first survey point, the more psychological symptoms they experienced one year later.

"These results suggest that psychological symptoms after cardiac arrest do not simply vanish. If untreated, they can persist. However, practicing mindfulness appears to be a potential protective factor against psychological symptoms and should, therefore, be studied further in this population," Presciutti said.

A limitation of the study is that nearly all the survivors were white and members of the same online support group, so these results might not be generalizable to all cardiac arrest survivors. Another limitation is that researchers measured mindfulness at one follow-up time point rather than at several different points in time.

"Our study team is currently following people who survive cardiac arrest from hospital discharge over time, looking at the potential roles of mindfulness and other protective factors on psychological symptoms," Presciutti said. "Our goal is to use the findings of these studies to develop interventions that may prevent and treat psychological symptoms in cardiac arrest survivors."

This study's findings support recommendations from the American Heart Association's scientific statement, "Psychological Health, Well-Being, and the Mind-Heart-Body Connection," published in January 2021. The statement notes that mindfulness-based interventions such as meditation or cognitive behavioral therapy can help decrease anxiety, perceived stress and depression, and they have a positive impact on cardiovascular disease and risk.

"There is a strong interconnection between the mind, heart and body. Psychological health is an important component of wellness and well-being for people with or at risk for cardiovascular disease," said Chair of the writing committee for the scientific statement, Glenn N. Levine, M.D., FAHA, a master clinician and professor of medicine at Baylor College of Medicine and chief of the cardiology section at the Michael E. DeBakey VA Medical Center, both in Houston. "Practicing mindfulness allows one to be more aware of and to have more control over one's emotional responses to the experiences of daily life. The findings of this study help us better understand who may benefit most from mindfulness interventions."