What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Paroxysmal atrial fibrillation (n=100). Intervention: Self-reported arrhythmia-provoking factors. Primary outcome: Most common self-reported arrhythmia-triggering factor (psychic stress).

August 3, 2004BMC Cardiovascular Disorders129 citationsOpen Access

Arrhythmia-provoking factors and symptoms at the onset of paroxysmal atrial fibrillation: A study based on interviews with 100 patients seeking hospital assistance

AHAnders HanssonLinköping University BMBjarne Madsen-HärdigLund University SOS. Bertil OlssonElectrophysiology

Key Result

Psychic stress was the most common self-reported triggering factor for paroxysmal atrial fibrillation (54%), followed by physical exertion (42%) and tiredness (41%).

Study Design

Type

Cross-Sectional (n=100)

Multicenter

Structured PICO

Population

100 patients (median age 59.9 years, 28% female) with idiopathic paroxysmal atrial fibrillation seeking hospital assistance, evaluated via structured questionnaire for arrhythmia-provoking factors and symptoms.

Outcome

Arrhythmia-provoking factors and symptoms associated with arrhythmia attacks assessed via structured questionnairepatient reported

In patients with paroxysmal atrial fibrillation, psychic stress is the most common self-reported trigger, and women experience significantly more anxiety, nausea, and swollen legs during attacks than men.

Limitations

Material was taken at a single hospital and is not representative of all patients with paroxysmal atrial fibrillation.
Ongoing treatment may have modified patients' recollections of anamnestic factors.
The material was not taken consecutively.
Patients with hypertension were not excluded, which could cause subtle diastolic changes.
The sample size is too limited to allow exploration of age-related symptoms.

Abstract

BACKGROUND: Surprisingly little information on symptoms of paroxysmal atrial fibrillation is available in scientific literature. Using questionnaires, we have analyzed the symptoms associated with arrhythmia attacks. METHODS: One hundred randomly-selected patients with idiopathic paroxysmal atrial fibrillation filled in a structured questionnaire. RESULTS: Psychic stress was the most common factor triggering arrhythmia (54%), followed by physical exertion (42%), tiredness (41%) coffee (25%) and infections (22%). Thirty-four patients cited alcohol, 26 in the form of red wine, 16 as white wine and 26 as spirits. Among these 34, red wine and spirits produced significantly more episodes of arrhythmia than white wine (p = 0.01 and 0.005 respectively). Symptoms during arrhythmia were palpitations while exerting (88%), reduced physical ability (87%), palpitations at rest (86%), shortage of breath during exertion (70%) and anxiety (59%). Significant differences between sexes were noted regarding swollen legs (women 21%, men 6%, p = 0.027), nausea (women 36%, men 13%, p = 0.012) and anxiety (females 79%, males 51%, p = 0.014). CONCLUSION: Psychic stress was the commonest triggering factor in hospitalized patients with paroxysmal atrial fibrillation. Red wine and spirits were more proarrhythmic than white wine. Symptoms in women in connection with attacks of arrhythmia vary somewhat from those in men.

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