Digital CBT Effectively Reduces Cardiac Anxiety and Improves Quality of Life After Heart Attack
Digital cognitive behavioral therapy (CBT) has been shown to significantly reduce cardiac-related anxiety and improve the quality of life and physical function of patients following a heart attack, according to a new randomized study published in the Journal of the American College of Cardiology. Researchers at Karolinska Institutet in Sweden compared digital CBT to standard care and found substantial benefits for those receiving the psychological intervention.
The Impact of Cardiac Anxiety
Many individuals who experience a heart attack develop persistent anxiety related to their cardiac health. This anxiety can manifest as a fear of future cardiac events or avoidance of everyday activities, including physical activity. This avoidance can significantly impact a patient’s overall well-being and recovery.
Study Design and Participants
The study involved 96 participants who had suffered a heart attack at least six months prior and were experiencing significant cardiac-related anxiety. Participants were randomly assigned to one of two groups: eight weeks of digital, exposure-based CBT or standard care, which consisted of routine medical follow-up without specific psychological treatment.
How Digital CBT Works
The digital CBT treatment involved exercises designed to help participants gradually confront situations and cardiac-related symptoms they had previously avoided due to fear. Participants completed self-assessments to track their symptoms both before and after the treatment period.
Key Findings: Improved Quality of Life and Reduced Anxiety
The results demonstrated that the group receiving digital CBT experienced a greater improvement in quality of life and a reduction in heart-related anxiety compared to the control group at the three-month follow-up. Importantly, these improvements remained stable up to one year after the completion of the treatment.
Increased Physical Functioning
In addition to improved mental well-being, participants in the digital CBT group also showed increased physical functioning. They reported feeling less limited in their daily lives and were more willing to engage in physical activity.
Expert Perspectives
“Our method focuses on reducing fear of cardiac-related symptoms. When the fear decreases, many dare to resume activities they had begun to avoid after their heart attack, which has a positive effect on their quality of life,” says Josefin Särnholm, licensed psychologist and researcher at the Department of Clinical Neuroscience, Karolinska Institutet.
Amanda Johnsson, licensed psychologist and doctoral student at the same institution, adds, “It is important to understand that cardiac-related anxiety is common after a heart attack and that it can be treated. Digital therapy can be a way to reach more patients.”
Future Research and Accessibility
Researchers are continuing to investigate the efficacy of digital CBT for cardiac anxiety, including a follow-up randomized controlled trial evaluating the intervention against a digital cardiac lifestyle intervention. This ongoing research aims to further refine and optimize the treatment protocol.
The study was a collaboration between researchers in psychology and cardiology at Karolinska Institutet and Karolinska University Hospital.
Publication Details: Amanda Johnsson et al, Digital Cognitive BehaviourTherapy for Cardiac Anxiety After Myocardial Infarction: Effects on Disease-Specific Health Status—Randomised Trial Results, Journal of the American College of Cardiology (2026). DOI: 10.1016/j.jacc.2026.02.5068