Online cognitive behavioral therapy targeting cardiac anxiety following myocardial infarction

Purpose and aimsThe purpose is to evaluate an online cognitive behavioral therapy (CBT) protocol with the aims to improve quality of life (QoL) and physical activity by reducing cardiac anxiety in patients following myocardial infarction (MI).BackgroundMI is a leading cause of mortality and morbidity in the population.

Cardiac anxiety (i.e., fear of cardiac symptoms and avoidance behavior) is a barrier to comply with cardiac rehabilitation post MI and is associated with poor QoL and recurrent adverse cardiac events.

Today, no evidence-based interventions directly target cardiac anxiety in MI patients.MethodsIn the present interdisciplinary research program, we will evaluate a CBT protocol targeting cardiac anxiety in post-MI patients, developed in two pilot studies.

Two randomized controlled trials, RCT1 with an education only control group (2023-2024) and RCT2 with active control group (2025-2026), will be conducted to assess the clinical effectiveness of CBT.

In addition to QoL and physical activity, the studies will be designed to investigate cardiac anxiety as treatment mechanism and assess health-economic outcomes.SignificanceIf CBT improves QoL and physical health among patients with a previous MI and cardiac anxiety, this will have significant impact on the structure of secondary prevention programs and public health effects.

Online CBT can be made accessible within the near future and implemented in clinical practice to the benefit of a large target population.