Abstract
Psychocardiology connects the biological reality of cardiovacular diseases with the subjective experience of the patient. In cases of cardiac arrhythmias, this relationship is particularly evident: cardiac arrhythmias are measurable electrophysiological events but they are also subjectively perceived, emotionally evaluated and embedded in a patient's biography. The objective burden of arrhythmia does not always correlate with the degree of subjective suffering. Although modern electrophysiology provides highly differentiated diagnostic and interventional treatment options, the question of the individual experience of illness often remains secondary. This article discusses cardiac arrhythmias from a psychocardiological and psychosomatic perspective. It focuses on the heart-brain axis, the role of anxiety, depression, hypervigilance and illness perception as well as atrial fibrillation as a model of a biopsychosocial disorder. In addition, the heart is considered as a special organ where its activity can be directly perceived and is culturally associated with life, safety, identity and vulnerability. Psychocardiology is not understood as psychologizing cardiac disease but as an integrative clinical attitude that takes both biological findings and subjective experience seriously.