What are triggers for atrial fibrillation?
What can cause an individual episode of atrial fibrillation? In a previous post, I discussed what are the causes of the long-term condition of atrial fibrillation, but in this segment, I will discuss things that can actually exacerbate or trigger an episode of atrial fibrillation.
Now, some of these triggers don't apply to everyone. Figuring out which triggers affect your atrial fibrillation means you needing to be a detective about your own atrial fibrillation to know what more commonly triggers your atrial fibrillation, so you know better what to avoid. What are some common triggers for atrial fibrillation?
Fatigue and Sleep Deprivation
Fatigue and sleep deprivation are common triggers for atrial fibrillation. When you are not sleeping well, there are a lot of stress hormones that get released. In addition you may be drinking more caffeine because you're sleep-deprived, and all of this can lead to episodes of atrial fibrillation, so good sleeping habits are essential to minimize episodes of atrial fibrillation. Poor sleep can also be a sign of undiagnosed sleep apnea. See my previous blog post about how sleep apnea can affect atrial fibrillation.
Another common trigger would be getting sick. Getting sick for any type of reason, whether it is a simple viral illness or something more serious, can then certainly trigger episodes of atrial fibrillation. However, I more commonly see this when patients are in the hospital, such as when people are in the hospital with more significant illness, whether that's a pneumonia or even a gastroenteritis or an infection on their leg. When they are more seriously ill or in the hospital, I very commonly see episodes of atrial fibrillation that get triggered. Your body is under a state of stress when you're sick, and again those stress type hormones can also cause episodes of atrial fibrillation.
Another thing that can trigger episodes of atrial fibrillation is just stress by itself. Stress by itself, whether that is stress at home, or stress at work, can lead to episodes of atrial fibrillation. How does stress increase episodes of atrial fibrillation? First, when people are in periods of stress, they may also have these stress-related hormones released that can trigger episodes of atrial fibrillation. Also, the habits that people have when they're stressed also can lead to episodes of atrial fibrillation. Those habits may include sleep deprivation. Perhaps you're not sleeping as much when you're stressed but other stress habits can include more caffeine intake because you're tired or more alcohol intake because you're stressed, and so all of those habits together can lead to episodes of atrial fibrillation.
For women in particular, there can be events of atrial fibrillation that are triggered during their menstrual cycle. I've had many female patients that describe palpitations or episode of atrial fibrillation during their menstrual cycle, but it's very inconsistent. It's not always during the middle of a cycle or at the end of the cycle. It can be very individualized.
The next thing that can trigger episodes of atrial fibrillation is exercise. There may be patients out there who clearly see that a certain type of exercise triggers atrial fibrillation. The tricky part about exercise induced atrial fibrillation is that exercise is actually healthy for you. In general, it is recommended that if you have atrial fibrillation that you should exercise, you should try to lose weight if overweight, and so exercise is always good. But exercise should be carefully monitored if you have atrial fibrillation. People with atrial fibrillation need to be careful when exercising to try to figure out where your own individual tolerances are. Usually I recommend to my patients to start off slow with things that are low-impact, and build up, as you are able to.
Also, heart rate monitors, whether that's a Fitbit or Apple watch, have been very useful for patients to monitor their exercise. They can be used to monitor your heart rate to help try to prevent episodes of atrial fibrillation while exercising. Of course while exercising staying hydrated is an important tip as well.
Over the Counter Supplements
Another thing that can trigger episodes of atrial fibrillation is over-the-counter supplements, particularly over-the-counter cold medications. Several over-the-counter cold medications contain a stimulant in them. If a cold supplement had a ‘D’ in part of the name, that ‘D’ stands for a decongestant, and that's usually some type of stimulant. It makes you feel better when you're sick, but it can also stimulate your heart and cause episodes of atrial fibrillation.
Alcohol can also trigger episodes of AFib. I've discussed in the past how alcohol influences atrial fibrillation, especially significant alcohol use. Binge drinking has been known to be a significant risk factor for developing atrial fibrillation to the point that it has its own term, called ‘holiday heart syndrome.’
In some patients, just a small amount of alcohol, even one or two drinks, can lead to episodes of atrial fibrillation. In general, I recommend to my patients that a small amount of alcohol, one or two drinks, is usually okay as long as it's not a clear trigger for your atrial fibrillation. If you clearly take one drink and you can tell that you have episodes of atrial fibrillation, then you should abstain alcohol completely, but small amounts are typically okay for most people.
Another trigger of atrial fibrillation is caffeine. Now, caffeine as a trigger for AFib has actually been something that's been controversial over the years. For many years previously, for patients with atrial fibrillation, it would be typically recommended to completely avoid all caffeine. Then as time went on, it was realized that some amounts of caffeine are safe. There was also a recent study that showed that small amounts of caffeine could be beneficial for atrial fibrillation.
Similar to alcohol, I recommend to my patients that caffeine, coffee, sodas are okay in small amounts as long as it's not clearly a trigger. There are, again, some patients that have told me, "If I drink one coffee, or I drink one soda, I'm going to get an episode of atrial fibrillation." In those cases, I do recommend patients to completely abstain from caffeine. However in most patients, a small amount of caffeine is not going to trigger an episode of atrial fibrillation.
Another thing that can lead to episodes of atrial fibrillation is dehydration. Dehydration is a very common trigger for atrial fibrillation and brings together some of the other points that I discussed earlier, topics like caffeine, dehydration, and stress. Some of the things that lead to the episode of atrial fibrillation is actually the dehydration. Caffeine and alcohol, for example, are powerful diuretics. As a result, if you're not drinking enough water to supplement, you can become dehydrated. Any type of dehydration can lead to episodes of atrial fibrillation.
Next thing that can trigger episodes of atrial fibrillation are recreational drugs. Even things like marijuana can stimulate your heart. Of course, more illicit drugs such as cocaine or stimulant types of recreational drugs also rev up your heart and can bring episodes of atrial fibrillation.
There are also some evidence that increased air pollution can cause episodes of atrial fibrillation. There have been some data showing that cities, when they have days of increased pollution, they get more patients experiencing episodes of atrial fibrillation.
Certain Foods and Beverages
The last trigger group is certain foods and beverages. This is not a specific trigger for everyone, but there are plenty of patients in mind that know that, for example, a fried food meal is going to trigger episodes of atrial fibrillation, or a particularly heavy meal is going to trigger an episode of AFib, or spicy food. Some of this goes back to being a detective about your diet. For example, knowing what you may have eaten 24 hours prior to when you get an AFib episode may help you figure out what food you particularly need to avoid. If you're looking for diet tips, look at my other for diet tips on atrial fibrillation.
Hopefully, with this summary of these different types of AFib triggers, you can help learn what may trigger your individual episodes of atrial fibrillation so you can better know what to avoid.
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