Monitoring of Potential Atrial Fibrillation Triggers May Reduce Episodes

Research findings from the I-STOP-AF Trial, presented at the American Heart Association’s Scientific Sessions 2021, suggest that patients with atrial fibrillation (AFib) who undergo individualized testing for potential triggers for their irregular heartbeats may experience less frequent AFib episodes.


According to lead study author, Gregory Marcus, MD, MAS, a professor of medicine at the University of California, San Francisco School of Medicine and associate chief of cardiology for research at UCSF Health, “there has been little research done on whether perceived triggers of AFib actually lead to AFib episodes. Our research team aimed to determine whether perceived triggers equate to actual triggers—and whether tracking triggers for AFib could lead to fewer episodes.” Among notable potential triggers, alcohol consumption was linked with experiencing an AFib episode, while caffeine did not appear to increase the risk of an episode.


The trial enrolled 446 participants, with 320 completing the study. Participants were randomized to monitor their AFib episodes without tracking triggers, or to test whether specific triggers—either picked from a menu or supplied by the patient—affected or caused AFib episodes. All participants performed a remote app-based trial while using a device to monitor AFib. The comparison took place over a period of 10 weeks. Patients in the trigger group reported less frequent AFib episodes in the four weeks after their testing compared to the tracking-only group.


Several limitations were noted, including that all study participants did not complete every assessment, and that the study relied on self-reported responses from patients with smartphones, among others. The study’s authors recommended more real-time testing, and suggested that robust testing of possible AFib triggers “can empower patients by alerting them to behaviors they can change in their daily lives.”