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Beta-blockers may alleviate emotion-triggered AF
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Beta-blockers reduced the effect of anger and stress in triggering atrial fibrillation, according to a study published in HeartRhythm.
“For years, our patients have come in the office and talked about the reason why they went into atrial fibrillation, describing a specific stressor or something that happened,” Rachel J. Lampert, MD, professor of internal medicine (cardiology) at Yale School of Medicine, told Cardiology Today. “Our study showed in a systematic fashion that in fact this was a real thing and not just anecdote. It’s very important to talk to your patients about what they think the triggers of their events are.”
Researchers analyzed data from 91 patients with symptomatic intermittent-persistent or paroxysmal AF within the past 6 months. Patients were categorized by whether they were prescribed beta-blockers (n = 54; mean age, 59 years; 61% men) or not (n = 37; mean age, 59 years; 70% men).
Rhythm surveillance was performed for 1 year with a standard non-looping chest plate event monitor and 24-hour ambulatory electrocardiographic monitoring on 1 day of each month. Patients used a diary to record their emotional intensity 30 minutes before symptom onset and during 24-hour Holter monitoring.
During the study, there were 163 episodes of symptomatic AF and 11,563 records of emotional intensity. AF was most likely to be associated with stress (OR = 2.92; 95% CI, 1.52-5.59) and anger (OR = 3.94; 95% CI, 2.12-7.34).
The effect of those two emotions were attenuated in patients prescribed beta-blockers (OR = 22.5; 95% CI, 6.7-75.4) compared with those who were not prescribed the medication (OR = 4; 95% CI, 1.7-9.5; P for interaction = .02).
Results were similar when patients on sotalol were excluded.
“Our findings suggest that taking beta-blockers only in situations in which they are prone to AF may be a strategy, an important avenue of future research,” Lampert said in an interview. “That’s a future direction that research could go, is to evaluate whether taking beta-blockers only as needed might be a strategy.” – by Darlene Dobkowski
For more information:
Rachel J. Lampert, MD, can be reached at Yale School of Medicine, 789 Howard Ave., Dana 319, New Haven, CT 06520; email: rachel.lampert@yale.edu.
Disclosures: The authors report no relevant financial disclosures.
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