Characterizing Patients With Cold Drink-Triggered Atrial Fibrillation

Area of Science:

• Cardiology
• Electrophysiology
• Preventive Medicine

Background:

• Atrial fibrillation (AF) is a prevalent arrhythmia with serious health consequences.
• Identifying modifiable lifestyle triggers for AF is crucial for patient management.
• A phenomenon termed "cold drink heart" (CDH) links cold food/drink consumption to AF episodes in a subset of patients, though literature is scarce.

Purpose of the Study:

• To characterize patient experiences with CDH.
• To assess the effectiveness of avoiding cold triggers in reducing AF recurrence.
• To evaluate physician awareness of CDH.

Main Methods:

• A mixed-methods study utilizing patient surveys and chart reviews.
• Recruitment of patients reporting CDH during emergency department visits or direct contact.
• Comparison of patients with CDH-only episodes versus those with both CDH and non-CDH AF episodes.

Main Results:

• 101 patients (75% male, median age of CDH onset 44.5 years) were included.
• Over half (51.5%) reported AF episodes exclusively after cold ingestion, often rapidly and associated with exertion.
• Avoiding cold intake was effective in 86.4% of cases, with 100% success in CDH-only patients.
• Physician awareness was low, with over half reporting dismissive attitudes.

Conclusions:

• Cold drink heart (CDH) is an under-recognized trigger for atrial fibrillation.
• Cold trigger avoidance demonstrates high efficacy in reducing AF recurrence, particularly in CDH-only patients.
• Further research is warranted to validate these findings and enhance healthcare provider education on CDH.