Association Between Atrial Fibrillation and Hearing Loss: A Cross-Sectional Study

BACKGROUND: Atrial fibrillation (AF) is associated with various end-organ complications through mechanisms including thromboembolism and microvascular dysfunction. The cochlea, with its high metabolic demands and limited collateral circulation, is particularly vulnerable to circulatory disturbances. However, the association between AF and hearing loss remains poorly understood, with limited and conflicting evidence from prior studies. Therefore, this study aimed to investigate the association between AF and hearing thresholds. METHODS: A single-center, cross-sectional study was conducted on 129 adults who underwent pure-tone audiometry, 12-lead electrocardiography, and 24-hour Holter monitoring. Subjects were categorized into an AF group (n=42) and a control group (n=87). The primary outcome was the better-ear average hearing threshold across 0.5, 1, 2, and 4 kHz. Generalized additive models were used to assess the association between AF and hearing thresholds, adjusting for age, sex, body mass index, and other cardiometabolic risk factors. Frequency-specific analyses were also conducted. RESULTS: After adjusting for covariates, AF was independently associated with a 4.28 dB HL elevation in hearing thresholds (95% CI: 3.47-5.10, P=.017). Frequency-specific analyses revealed that the association was most pronounced at 4 kHz, with a 7.40 dB HL elevation at this frequency (95% CI: 2.27-10.05, P=.004). CONCLUSION: This study provides preliminary evidence of an association between AF and hearing loss, suggesting that AF could be considered in investigations aimed at identifying modifiable risk factors for hearing loss.