Digital CBT Reduces Heart Anxiety & Improves Life After Heart Attack

Digital CBT Offers Lasting Relief for Cardiac Anxiety After Heart Attack

A new study published in the Journal of the American College of Cardiology demonstrates that digital Cognitive Behavioral Therapy (CBT) significantly reduces cardiac-related anxiety and improves quality of life for patients recovering from a heart attack. Researchers at Karolinska Institutet found that an eight-week program of digital, exposure-based CBT led to sustained improvements in anxiety levels and physical function, lasting up to one year after treatment completion. March 25, 2026, Karolinska Institutet announced the findings.

Cardiac anxiety – encompassing fears of future cardiac events and avoidance of physical activity – is a common and debilitating consequence of heart attacks. The study addressed a critical gap in post-heart attack care by focusing on the psychological well-being of patients. Researchers enrolled 96 individuals who had experienced a heart attack at least six months prior and were experiencing significant cardiac-related anxiety. Participants were randomly assigned to either the digital CBT program or standard care, which consisted of routine medical follow-up without dedicated psychological intervention.

The digital CBT program centered on exposure-based exercises. Participants gradually confronted situations and physical sensations related to their heart condition that they had previously avoided due to fear. This approach, delivered digitally, allowed for convenient and accessible treatment. Participants self-assessed their symptoms both before and after the intervention, providing quantifiable data on the program’s effectiveness.

The results revealed a clear advantage for the CBT group. At the three-month follow-up, those who received digital CBT reported a marked improvement in their quality of life and a substantial reduction in heart-related anxiety compared to the control group. Importantly, these benefits remained stable for a year post-treatment. The treatment group demonstrated increased physical functioning, reporting less limitation in daily activities and a greater willingness to engage in physical activity.

“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,”

Josefin Särnholm, licensed psychologist and researcher, Department of Clinical Neuroscience, Karolinska Institutet

Amanda Johnsson, first author and doctoral student at Karolinska Institutet, emphasized the importance of addressing cardiac anxiety. “It’s 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,” she stated.

This research builds on a growing body of evidence supporting the efficacy of CBT in managing anxiety disorders. The shift towards digital delivery represents a significant step forward in accessibility, potentially overcoming barriers related to cost, location, and stigma often associated with traditional mental healthcare. The study was a collaborative effort between researchers in psychology and cardiology at Karolinska Institutet and Karolinska University Hospital, and was funded by the Swedish Heart-Lung Foundation and the Swedish Research Council.

Looking ahead, researchers will likely explore the scalability and cost-effectiveness of digital CBT programs for cardiac anxiety. Further investigation into tailoring these programs to individual patient needs and integrating them seamlessly into existing cardiac rehabilitation programs could maximize their impact. The findings underscore the critical need for a holistic approach to post-heart attack care, recognizing the interconnectedness of physical and mental health.