Patient-reported triggers of paroxysmal atrial fibrillation.
Alcohol
Atrial fibrillation
Atrial flutter
Caffeine
Triggers
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
16
11
2018
pubmed:
18
2
2019
medline:
4
11
2020
entrez:
18
2
2019
Statut:
ppublish
Résumé
Triggers for discrete atrial fibrillation (AF) events remain poorly studied and incompletely characterized. The purpose of this study was to describe common triggers for AF and their relationships with patient characteristics. We invited symptomatic, paroxysmal AF patients enrolled in the Health eHeart Study and through the patient-centered advocacy organization StopAfib.org to complete a questionnaire regarding their AF triggers and cardiovascular risk factors. Of 1295 participants with symptomatic AF, 957 (74%) reported triggers for episodes of AF. In comparison to participants without triggers and after multivariate adjustment, those reporting triggers had a 71% lower odds of congestive heart failure (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.14-0.60; P = .001) and a >2-fold greater odds of a family history of AF (OR 2.04; 95% CI 1.21-3.47; P = .008). The most commonly reported triggers were alcohol (35%), caffeine (28%), exercise (23%), and lack of sleep (21%). Multivariable models revealed that younger patients, women, and those with an AF family history more commonly experienced various triggers. Patients reported a median of 2 different triggers (interquartile range 1-3). Female sex, Hispanic ethnicity, obstructive sleep apnea, and a family history of AF were each associated with a greater number of AF triggers. Vagally mediated triggers tended to cluster together within individuals. The majority of patient-reported triggers are modifiable, potentially identifying accessible means to prevent and reduce AF episodes. Exploring the interactions between AF patient type, including underlying genetic differences, and common exposures may be fruitful areas of investigation.
Sections du résumé
BACKGROUND
Triggers for discrete atrial fibrillation (AF) events remain poorly studied and incompletely characterized.
OBJECTIVE
The purpose of this study was to describe common triggers for AF and their relationships with patient characteristics.
METHODS
We invited symptomatic, paroxysmal AF patients enrolled in the Health eHeart Study and through the patient-centered advocacy organization StopAfib.org to complete a questionnaire regarding their AF triggers and cardiovascular risk factors.
RESULTS
Of 1295 participants with symptomatic AF, 957 (74%) reported triggers for episodes of AF. In comparison to participants without triggers and after multivariate adjustment, those reporting triggers had a 71% lower odds of congestive heart failure (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.14-0.60; P = .001) and a >2-fold greater odds of a family history of AF (OR 2.04; 95% CI 1.21-3.47; P = .008). The most commonly reported triggers were alcohol (35%), caffeine (28%), exercise (23%), and lack of sleep (21%). Multivariable models revealed that younger patients, women, and those with an AF family history more commonly experienced various triggers. Patients reported a median of 2 different triggers (interquartile range 1-3). Female sex, Hispanic ethnicity, obstructive sleep apnea, and a family history of AF were each associated with a greater number of AF triggers. Vagally mediated triggers tended to cluster together within individuals.
CONCLUSION
The majority of patient-reported triggers are modifiable, potentially identifying accessible means to prevent and reduce AF episodes. Exploring the interactions between AF patient type, including underlying genetic differences, and common exposures may be fruitful areas of investigation.
Identifiants
pubmed: 30772533
pii: S1547-5271(19)30099-2
doi: 10.1016/j.hrthm.2019.01.027
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
996-1002Informations de copyright
Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.