Tag: atrial fibrillation

Categories : Cardiovascular DiseaseTags :

Alcohol Triggers AF – But Not Caffeine or Other Likely Culprits

On By ModernMedia
Photo by Pavel Danilyuk on Pexels

Researchers have found that, out of possible triggers they tested, only alcohol use was consistently associated with more episodes of atrial fibrillation (AF). The study, published in JAMA Cardiology, did not find that the other triggers, caffeine, sleep deprivation and sleeping on the left side, to be associated with the common heart condition.

A surprising finding was that, although most of the things that participants thought to be related to their AF were not, those in the intervention group still had less arrhythmia than the people in a non self-monitoring control group.

“This suggests that those personalised assessments revealed actionable results,” said lead author Gregory Marcus, MD, MAS, professor at University of California, San Francisco. “Although caffeine was the most commonly selected trigger for testing, we found no evidence of a near-term relationship between caffeine consumption and atrial fibrillation. In contrast, alcohol consumption most consistently exhibited heightened risks of atrial fibrillation.”

Although caffeine was the most commonly selected trigger for testing, we found no evidence of a near-term relationship between caffeine consumption and atrial fibrillation.

In a brainstorming session, patients had said researching individual triggers for AF was their top priority, giving rise to the I-STOP-AFib study, which enabled individuals to test any presumed AF trigger. About 450 people participated, 58% male and 92% white.

Participants used a mobile electrocardiogram recording device along with a phone app to log potential triggers like drinking alcohol and caffeine, sleeping on the left side or not getting enough sleep, eating a large meal, a cold drink, or sticking to a particular diet, engaging in exercise, or anything else they thought was relevant to their AF. While participants were most likely to select caffeine as a trigger, there was no association with AF. Recent research has similarly failed to show a link between caffeine and arrhythmias – on the contrary, investigators found it may have a protective effect.

The new study demonstrated that consumption of alcohol was the only trigger that consistently resulted in significantly more self-reported AF episodes.

The individualised ‘n-of-1’ testing method did not validate participant-selected triggers for AF. But trial participants did report fewer AF episodes than those in the control group, and the data suggest that behaviours like avoiding alcohol could lessen the chances of having an AF episode.
“This completely remote, siteless, mobile-app based study will hopefully pave the way for many investigators and patients to conduct similar personalised ‘n-of-1’ experiments that can provide clinically relevant information specific to the individual,” said Prof Marcus.

Source: University of California, San Francisco

Categories : Cardiovascular DiseaseTags :

A Glass of Wine Raises Atrial Fibrillation Risk

On By ModernMedia
Photo by <a href="https://unsplash.com/@apolophotographer?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText">Apolo Photographer</a> on <a href="https://unsplash.com/s/photos/wine?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText">Unsplash</a>
Photo by Apolo Photographer on Unsplash

A single glass of wine can rapidly increase the risk of atrial fibrillation, according to new research published in Annals of Internal Medicine.

The study provides the first evidence that alcohol consumption significantly increases the chance of the heart rhythm condition occurring within a few hours, and is contrary to the notion of a cardioprotective effect of alcohol.

“Contrary to a common belief that atrial fibrillation is associated with heavy alcohol consumption, it appears that even one alcohol drink may be enough to increase the risk,” said Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF.

“Our results show that the occurrence of atrial fibrillation might be neither random nor unpredictable,” he said. “Instead, there may be identifiable and modifiable ways of preventing an acute heart arrhythmia episode.”

Atrial fibrillation (AF) is the most common heart arrhythmia seen clinically, but until now research has largely focused on risk factors and treatments for the disease, rather than what can trigger episodes. Large studies have established that chronic alcohol consumption can be a predictor for AF, and Marcus and other scientists have demonstrated that it is linked to increased risk for a first diagnosis of atrial arrhythmias.  

The research centered on 100 patients with documented AF who consumed at least one alcoholic drink a month, but without substance use disorders, certain allergies, or changing medications.

Each participant wore an electrocardiogram (ECG) monitor for roughly four weeks, pressing a button whenever they had a standard-size alcoholic drink. They were also all fitted with a continuously recording alcohol sensor. Blood tests reflecting alcohol consumption over the previous weeks were periodically administered. Participants consumed a median of one drink per day throughout the study period.

Researchers found that an AF episode was associated with two-fold higher odds with one alcoholic drink, and three-fold higher odds with two or more drinks within the preceding four hours. Increased blood alcohol concentration was also associated with AF episodes.

Study limitations included patients possibly forgetting to press their monitor buttons or minimising the number of button presses due to embarrassment, although these considerations would not have affected alcohol sensor readings. The study was also limited to those with established AF, not to the general population.

“The effects seem to be fairly linear: the more alcohol consumed, the higher the risk of an acute AF event,” said Prof Marcus. “These observations mirror what has been reported by patients for decades, but this is the first objective, measurable evidence that a modifiable exposure may acutely influence the chance that an AF episode will occur.”

Source: University of California – San Francisco

Categories : Ageing Cardiovascular DiseaseTags :

Screening for AF in the Elderly Using Thumb ECGs Reduces Stroke Risk

On By ModernMedia

Screening for atrial fibrillation in 75- and 76-year-olds using thumb ECGS could reduce the risk of stroke, severe bleeding and death, according to a large-scale Swedish study.

Atrial fibrillation (AF) is associated with a five-fold increased risk of stroke, and the symptoms are often deleterious since large blood clots can form in the heart, breaking free and posing a stroke risk. Still, countries do not screen the general population for atrial fibrillation, but rather treat those patients who are discovered during routine care. This study by the Karolinska Institutet in Sweden and published in The Lancet, investigated the effectiveness of screening for AF.

“There has never really been a study that examines if it would be beneficial to screen for atrial fibrillation, which is why we wanted to investigate it,” said Emma Svennberg, cardiologist at the Karolinska University Hospital, Huddinge, and researcher at the Department of Medicine, Huddinge, Karolinska Institutet.

The study included almost 28 000 participants aged 75 or 76, randomised to be invited either to screening or to a control group, who received standard care. Of those invited to screening, more than half choose to participate. They completed a health questionnaire and performed a so-called thumb ECG (electrocardiogram), which involves placing one’s thumbs on an ECG device that measures the heart’s electrical activity.

Those without atrial fibrillation were asked to record their heart rhythm twice daily for two weeks using the ECG device which they took home. If the device registered irregular heart rhythms, the participants were referred to a cardiologist for a standardised work-up and, if there were no contra-indications, initiation of oral anticoagulant therapy.

The study’s 28 000 participants were then followed for at least five years. More detections of atrial fibrillation were recorded in the screening group, which also had a slightly lower incidence of death, stroke and severe bleeding than the control group.

“In total, 31.9 percent of those in the screening group experienced a negative event compared to 33 percent in the control group,” said Johan Engdahl, adjunct lecturer at the Department of Clinical Sciences, Danderyds Hospital, at Karolinska Institutet. “Now, that may sound like a small difference, but you must bear in mind that only about half of those invited to screening participated and it’s possible we would have seen a more pronounced difference had more people turned up for screening. Those who participated in the screening had significantly fewer negative events.”

Based on the findings, the researchers estimated that at least 2300 cases of stroke or death could be avoided per year in Sweden if a national screening of atrial fibrillation in the elderly was introduced.

Source: Karolinska Institute