Abstract 12052: Patient-Reported Triggers of Paroxysmal Atrial Fibrillation.

Introduction: While long-term risk factors for new onset atrial fibrillation (AF) have been well-established, triggers for discrete episodes remain poorly studied and incompletely characterized. Hypothesis: We sought to describe common triggers for AF episodes and their relationships with patient characteristics. Methods: We invited symptomatic, paroxysmal AF patients enrolled in the Health eHeart Study and subscribers to StopAfib.org to complete a questionnaire regarding their AF triggers and cardiovascular risk factors. Results: Of 1,295 participants with symptomatic AF, 957 (74%) reported triggers for episodes of AF. In comparison to those without triggers and after multivariate adjustment, those reporting triggers had a 58% lower odds of congestive heart failure (odds ratio [OR] 0.29, 95% CI 0.14 to 0.60, p=0.001) and almost a two-fold greater odds of a family history of AF (OR 2.04, 95% CI 1.21 to 3.47, p=0.008). The most commonly reported triggers were alcohol (in 35%), caffeine (in 28%), exercise (in 23%), and lack of sleep (in 21%) [Figure]. Multivariable models revealed that younger patients, women, and those with a family history of AF more commonly experienced certain AF triggers. Overall, patients reported a median of two different triggers (interquartile range 1-3); female sex, Hispanic ethnicity, a history of obstructive sleep apnea, and a family history of AF were each associated with reporting a greater number of triggers. Within individuals, vagally-mediated triggers tended to cluster together. Conclusions: The majority of patient-reported triggers are modifiable, potentially identifying accessible means to prevent and reduce AF episodes. Exploring the interactions between AF patient type, including underlying genetic differences, and common exposures may prove to be a fruitful area of investigation. [ABSTRACT FROM AUTHOR]