In the Journals

Common triggers for AF episodes modifiable

Common triggers for atrial fibrillation included caffeine, alcohol, lack of sleep and exercise, according to a study published in HeartRhythm.

“Better understanding of individual-level triggers may help empower patients and represents a novel approach to improving quality of life and reducing health care use for AF,” Gregory Marcus, MD, MAS, cardiologist and director of clinical research in the division of cardiology at the University of California, San Francisco, said in a press release.

Christopher A. Groh, MD, clinical fellow at the University of California, San Francisco, and colleagues analyzed data from 1,295 participants with symptomatic AF from the Health eHeart study. Participants completed a questionnaire to collect information about AF symptoms, potential triggers for episodes, known risk factors for AF and CVD, and general demographics.

Specific triggers included in the questionnaire were caffeine, alcohol, exercise, lack of sleep, consuming cold beverages, not exercising, high sodium diet, consuming cold foods, dehydration, consuming large meals and lying on one’s left side. Participants were also able to add other specific triggers.

Of the participants in the study, 74% reported triggers for AF episodes (mean age, 63 years; 50% women). Participants reported a median of two different triggers related to AF. The triggers most commonly reported were alcohol (35%), caffeine (28%), exercise (23%) and lack of sleep (21%), the researchers wrote.

Various triggers were more likely to be reported by women, younger participants and those with a family history of AF. Participants with multiple triggers were also more likely to be women, those with a history of sleep apnea, Hispanic and with a family history of AF.

Compared with participants without triggers, those with triggers were more likely to have a family history of AF (OR = 2.04; 95% CI, 1.21-3.47) and less likely to have congestive HF (OR = 0.29; 95% CI, 0.14-0.6) after multivariate adjustment, according to the study.

Participants often reported more than one vagal trigger, which included cold food, cold beverage and large meals.

“The particular relevance of triggers among those with a family history of AF suggests that better understanding [of] gene-environment interactions may reveal novel mechanisms and ultimately help to counsel patients regarding appropriate lifestyle interventions,” Groh and colleagues wrote. – by Darlene Dobkowski

Disclosures: Marcus reports he received research funding from Jawbone and Medtronic, is a consultant for InCarda and Johnson & Johnson and holds equity in InCarda. Groh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

 

Common triggers for atrial fibrillation included caffeine, alcohol, lack of sleep and exercise, according to a study published in HeartRhythm.

“Better understanding of individual-level triggers may help empower patients and represents a novel approach to improving quality of life and reducing health care use for AF,” Gregory Marcus, MD, MAS, cardiologist and director of clinical research in the division of cardiology at the University of California, San Francisco, said in a press release.

Christopher A. Groh, MD, clinical fellow at the University of California, San Francisco, and colleagues analyzed data from 1,295 participants with symptomatic AF from the Health eHeart study. Participants completed a questionnaire to collect information about AF symptoms, potential triggers for episodes, known risk factors for AF and CVD, and general demographics.

Specific triggers included in the questionnaire were caffeine, alcohol, exercise, lack of sleep, consuming cold beverages, not exercising, high sodium diet, consuming cold foods, dehydration, consuming large meals and lying on one’s left side. Participants were also able to add other specific triggers.

Of the participants in the study, 74% reported triggers for AF episodes (mean age, 63 years; 50% women). Participants reported a median of two different triggers related to AF. The triggers most commonly reported were alcohol (35%), caffeine (28%), exercise (23%) and lack of sleep (21%), the researchers wrote.

Various triggers were more likely to be reported by women, younger participants and those with a family history of AF. Participants with multiple triggers were also more likely to be women, those with a history of sleep apnea, Hispanic and with a family history of AF.

Compared with participants without triggers, those with triggers were more likely to have a family history of AF (OR = 2.04; 95% CI, 1.21-3.47) and less likely to have congestive HF (OR = 0.29; 95% CI, 0.14-0.6) after multivariate adjustment, according to the study.

Participants often reported more than one vagal trigger, which included cold food, cold beverage and large meals.

“The particular relevance of triggers among those with a family history of AF suggests that better understanding [of] gene-environment interactions may reveal novel mechanisms and ultimately help to counsel patients regarding appropriate lifestyle interventions,” Groh and colleagues wrote. – by Darlene Dobkowski

Disclosures: Marcus reports he received research funding from Jawbone and Medtronic, is a consultant for InCarda and Johnson & Johnson and holds equity in InCarda. Groh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.