Atrial fibrillation: 13 triggers of an A-fib attack

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Here are some factors that may cause A-fib to appear or recur.

1. Travel

Traveling will not cause A-fib, but it can involve stress and insomnia, which are possible triggers of A-fib.

When traveling, people with A-fib should be sure to:

• get enough sleep
• stay hydrated
• eat regular meals
• keep medications in their hand baggage when flying
• check with a doctor before flying if they have a severe condition
• take measures to manage stress, for example, by planning trips carefully beforehand

TIps for coping with travel anxiety

2. Medical procedures

Up to 6 in 10 people have A-fib after cardiac surgery. This can have both long- and short-term effects on cardiovascular health.

A-fib also affects 3–30% of people after noncardiac surgery, with a higher risk following surgery in the thoracic (mid back) or chest area. It usually occurs within 48 hours and can increase the risk of stroke and other complications.

Anyone with A-fib should let their doctor know before undergoing any medical procedure, even a minor one.

3. Prescription medications

There is some evidence that certain prescription drugs may trigger a first episode of A-fib, according to a 2012 study.

They include:

• cardiovascular drugs, such as adenosine, dobutamine, and milrinone
• corticosteroids
• ondansetron
• antitumor agents, such as paclitaxel, mitoxantrone, and anthracyclines

A doctor should advise a person on possible adverse effects before prescribing these and other drugs for the first time.

4. Exercise

Low- or moderate-intensity exercise is generally beneficial for heart health. However, long-term, high-intensity endurance training may increase the risk of A-fib, especially in males, according to some research.

People with A-fib who wish to start exercising or increase their activity levels should speak with a doctor to ensure they have a safe approach.

What is the best way to start exercising?

5. Alcohol

High alcohol consumption and drinking a lot in a short time — known as binge drinking — can increase the risk of A-fib. However, people can also experience A-fib with a more moderate but regular alcohol intake, according to research.

Possible reasons for this include:

• alcohol’s toxic effect on the body
• alcohol’s contribution to obesity and high blood pressure
• a higher risk of sleep-disordered breathing, or sleep apnea

See some apps to help people stop drinking

6. Stress

Stress has links with various aspects of heart disease, including A-fib. However, it is unclear to what extent A-fib results from stress or causes it.

Some scientists believe there may be a two-way link between stress and A-fib and that reducing stress could help manage or even reverse A-fib.

Ways of managing stress include recognizing and taking steps to avoid individual triggers and doing activities such as yoga, deep breathing, and tai chi.

7. Sleep problems

In 2017, the authors of a Taiwanese study proposed that insomnia might increase the risk of A-fib, but doctors need more research to confirm the link. The study did not consider other factors, such as smoking, alcohol use, and blood pressure.

A-fib is common among people with obstructive sleep apnea (OSA), research shows. The risk is higher for older people and those with high blood pressure. Experts recommend that people with OSA should speak with their doctor about their heart health.

8. Air pollution

A 2021 review found evidence that short-term exposure to certain pollutants — notably nitrogen dioxide and sulfur dioxide — can increase the risk of an A-fib episode.

Meanwhile, people living in areas with long-term exposure to air pollution are more likely to have A-fib than people in less-polluted areas.

9. Dehydration and overhydration

Consuming too much or too little water may increase the risk of A-fib.

Dehydration and overhydration can both lead to an imbalance or lack of electrolytes, such as sodium and potassium. This may trigger A-fib symptoms. Dehydration may also make it easier for blood to coagulate, increasing the risk of blood clots.

Dehydration can occur during exercise, hot weather, and illness that causes vomiting or diarrhea. Overhydration can affect people who drink too much water, for instance, while exercising.

How much water should I drink each day?

10. Caffeine

People have often reported that caffeine, particularly coffee, is a trigger for A-fib. However, scientific evidence suggests the answer may not be so clear cut.

According to one review, people may be less likely to have A-fib if they drink 1–7 cups of caffeinated coffee per week. Another study suggests that males who drink 1–3 cups of coffee per day may have a lower risk of A-fib than if they drank no coffee or 4 or more cups per day.

The best option is probably for people with A-fib to avoid caffeine or drink it in moderation until there is more proof that it has no ill effects on their condition.

Is caffeine bad for you?

11. Energy drinks

Energy drinks can contain high levels of caffeine and other stimulants, such as guarana and eviodamine. These substances can affect heart rhythms and may be unsuitable for people with A-fib.

What are some natural energy drinks?

12. Over-the-counter drugs

Over-the-counter (OTC) cold, flu, and cough medications can trigger A-fib attacks if they contain phenyephrine or pseudoephedrine. These ingredients can stimulate the heart.

What can get rid of a cough?

13. Recreational drugs

Recreational and street drugs, such as methamphetamine, cocaine, opioids, and cannabis, can affect heart rate and may trigger an A-fib attack. Some experts believe that quitting the use of these drugs may reverse A-fib in people with symptoms.

Can foods trigger A-fib? What should I eat if I have A-fib?

Some people have a higher risk of developing A-fib.

Risk factors for A-fib include:

1. Hypertension, or high blood pressure
2. A history of heart disease, heart attack, or heart surgery
3. A personal or family history of hormonal problems, such as thyroid disease
4. Obstructive sleep apnea
5. Obesity
6. Smoking
7. Hypoventilation syndrome, which involves shallow or inadequate breathing
8. Using certain medications and recreational drugs
9. A history of rheumatic fever
10. A history of pericarditis
11. Hyperlipidemia
12. Being aged over 65 years
13. Chronic stress

What are the risk factors for chronic A-fib?

Here are some tips that may help a person avoid A-fib episodes:

1. Do regular exercise.
2. Establish regular sleep patterns.
3. Manage stress.
4. Avoid alcohol or drink only in moderation.
5. Quit smoking, which may reduce the risk of complications by 35%.
6. Follow a heart-healthy diet.
7. Maintain a moderate weight.
8. Stay hydrated.
9. Follow any treatment plan for A-fib.
10. Check that medications, supplements, and other substances are safe to use.

What are some more natural remedies for A-fib?

Here are some questions people often ask about managing A-fib.

What should you avoid if you have A-fib?

People with A-fib should avoid:

• alcohol
• tobacco
• excessive caffeine intake
• certain recreational, prescription, and OTC drugs

They should also follow their doctor’s instructions and seek medical advice before increasing exercise levels or making significant changes to their diet or supplement intake.

Can A-fib start suddenly and for no apparent reason?

A-fib often occurs in response to a trigger, such as surgery or caffeine consumption. However, some people may experience paroxysmal A-fib, which lasts less than 7 days and then resolves. This can still increase the risk of stroke and may be a sign of an underlying problem. A person should seek medical advice if it happens.

A-fib indicates there is a problem with the cardiovascular system. A range of heart problems can lead to A-fib, and various triggers may provoke an initial episode or a recurrence. These range from an overconsumption of energy drinks to cardiac or noncardiac surgery.

Individuals with a diagnosis of A-fib may benefit from keeping a diary of when symptoms occur in order to identify and, where possible, avoid their triggers.