Beta-Blockers May Moderate Impact of Stress on Atrial Fibrillation
TUESDAY, June 4, 2019 -- β-blockers can attenuate the impact of anger or stress on atrial fibrillation (AF), according to a study published online June 4 in HeartRhythm.
Rachel Lampert, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues examined whether β-blockers can protect against emotionally triggered AF. For one year, 91 patients with a history of paroxysmal or persistent AF recorded their rhythm on event monitors at the time of AF symptoms and completed a diary entry relating to mood states for the previous 30 minutes. Patients also underwent monthly 24-hour Holter monitoring, during which they completed diary entries twice per hour.
The researchers found that 60 percent of the patients were prescribed β-blockers. In 34 patients, associated diary data were available for 163 symptomatic AF episodes and 11,563 Holter-confirmed sinus rhythm control periods. During anger or stress, the likelihood of an AF episode was significantly higher. In patients on β-blockers, this effect was significantly attenuated (odds ratios, 22.5 for patients not prescribed β-blockers and 4.0 for patients prescribed β-blockers).
"While the effect of β-blockers on the overall prevalence of AF could not be evaluated in this nonrandomized study, they did reduce the ability of anger or stress to trigger AF," the authors write. "Identifying patients with AF prone to emotional triggering may be one strategy to target BBs to those most likely to benefit."
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Posted: June 2019