Our very first LAF Survey in February 2001 clearly established that emotional and work-related stress are important triggers for the initial and subsequent afib episodes. A later, considerably larger, survey carried out in June 2001, refined this finding with the observation that emotional stress is predominantly a trigger for adrenergic afibbers where 94% of respondents listed stress as their most important trigger. In contrast, only 29% of vagal afibbers listed stress as an important trigger. Among mixed afibbers, 56% listed stress as an important trigger.

A group of researchers from Yale University and the University of California now confirm our findings. Their 1-year study involved 75 paroxysmal or persistent afibbers with adrenergically mediated afib, 60% of whom were male and 60% of whom were taking beta-blockers. The study participants kept detailed diaries recording their mood states every 30 minutes, as well as at the end of each day. They were also equipped with event monitors which recorded all their afib episodes. Detailed analysis showed that participants (not taking beta-blockers) reporting �feeling happy� in a diary entry were 10 times less likely to experience an afib episode within the next 30 minutes than were those reporting a neutral mood state. On the other hand, those reporting feeling sad were 8 times more likely to experience an episode within 30 minutes of recording this feeling. Anger and worry were other significant triggers, with anger being particularly bad for men and worry being particularly detrimental for women.

Circulation, Vol. 118, No. 18S, October 28, 2008, Abstract #1036