We read with great interest the case report by Hughes and Schneir, “Paroxysmal Atrial
Fibrillation Associated with the Trigger Sequence of Strenuous Exercise Followed by
Cold Water Ingestion,” which describes a trigger sequence for atrial fibrillation
that is not well documented in the literature (
1
). The patient, a healthy 64-year-old man with no history of atrial fibrillation,
experienced two isolated episodes of atrial fibrillation, both triggered by the specific
sequence of strenuous exercise followed by ingestion of cold water. Both episodes
of atrial fibrillation resolved with electrical cardioversion. His cardiac evaluation
was unremarkable. Over the subsequent seven years, he avoided this particular trigger
dyad and had not experienced a recurrence of atrial fibrillation—although he had continued
to engage in strenuous exercise without cold drinks and to drink his cold beverages,
but not in a post-exertional state. As only the combination threw him into atrial
fibrillation, only the combination needed to be avoided to maintain effective rhythm
control.To read this article in full you will need to make a payment
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References
- Paroxysmal atrial fibrillation associated with the trigger sequence of strenuous exercise followed by cold water ingestion.J Emerg Med. 2022; 62: 390-392
- Paroxysmal atrial fibrillation and brain freeze: a case of recurrent co-incident precipitation from a frozen beverage.Am J Case Rep. 2016; 17: 23-26
- Redressing underrecognition of "cold drink heart": patients teaching physicians about atrial fibrillation triggered by cold drink and food.Perm J. 2020; 24 (19): 238
- Individualized studies of triggers of paroxysmal atrial fibrillation: the I-STOP-AFib randomized clinical trial.JAMA Cardiol. 2022; 7: 167-174
Article info
Publication history
Published online: June 15, 2022
Accepted:
June 4,
2022
Received:
May 18,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
