ArticleHeart rhythm2019
Effect of β-blockers on triggering of symptomatic atrial fibrillation by anger or stress.
Article in Heart rhythm, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Psychological aspects of atrial fibrillation: A systematic narrative review : Impact on incidence, cognition, prognosis, and symptom perception.Current cardiology reports · 2020Pooled it
- Relationship between psychological factors and atrial fibrillation: A meta-analysis and systematic review.Medicine · 2020Pooled it
- Arrhythmia Risk During the 2016 US Presidential Election: The Cost of Stressful Politics.Journal of the American Heart Association · 2021Trial
- Dynamic Electrocardiogram under P Wave Detection Algorithm Combined with Low-Dose Betaloc in Diagnosis and Treatment of Patients with Arrhythmia after Hepatocarcinoma Resection.Journal of healthcare engineering · 2021Trial
- Neuropsychiatry of atrial fibrillation: dementia and beyond.Frontiers in cardiovascular medicine · 2025Review
- Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation.Open heart · 2024Article
- Anger frequency and risk of cardiovascular morbidity and mortality.European heart journal open · 2022Article
- Beta-blockers in cardiac arrhythmias-Clinical pharmacologist's point of view.Frontiers in pharmacology · 2022Review
- A SMART approach to reducing paroxysmal atrial fibrillation symptoms: Results from a pilot randomized controlled trial.Heart rhythm O2 · 2021Article
- Challenges and opportunities to developing a frailty index using electronic health record data.Journal of geriatric oncology · 2021Article
- Psychological stress in heart failure: a potentially actionable disease modifier.Heart failure reviews · 2021Review
- Effects of β-Blockers on the Sympathetic and Cytokines Storms in Covid-19.Frontiers in immunology · 2021Review
- Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and "First Do No Harm" Part III.Current urology reports · 2020Review
- The "Road" to Atrial Fibrillation: The Role of the Cardiac Autonomic Nervous System.Journal of atrial fibrillationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAnger and stress can trigger episodes of atrial fibrillation (AF) in patients with a history of AF.
objectiveThe purpose of this study was to determine whether β-blockers can protect against emotionally triggered AF.
methodsIn this prospective, controlled, electronic diary-based study of emotions preceding AF, patients with a history of paroxysmal or persistent AF (N = 91) recorded their rhythm on event monitors at the time of AF symptoms and completed a diary entry querying mood states (eg, anger and stress) for the preceding 30 minutes (pre-AF "case period") for 1 year. Also, patients underwent monthly 24-hour Holter monitoring during which they were prompted to complete a diary entry twice per hour. Diaries recorded during sinus rhythm comprise controls. Patients' exposure to each emotion was compared between the pre-AF case period and control periods by using generalized estimating equation modeling, as well as interactions between β-blocker use and emotion tested.
resultsSixty percent were prescribed β-blockers. A total of 163 symptomatic AF episodes (in 34 patients) and 11,563 Holter-confirmed sinus rhythm control periods had associated diary data. Overall, the likelihood of an AF episode was significantly higher during anger or stress. This effect, however, was significantly attenuated in patients on β-blockers (odds ratio 22.5; 95% confidence interval 6.7-75.4, P < .0001 for patients not prescribed β-blockers vs odds ratio 4.0, 95% confidence interval 1.7-9.5, P = .002 for those prescribed β-blockers; P = .02 for the interaction). Exclusion of patients on sotalol did not affect findings.
conclusionAnger or stress can trigger AF, but use of β-blockers greatly attenuates this deleterious physiological response.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.