Temperament, stress, and atrial fibrillation

Abstract

In some patients with atrial fibrillation (AF), the causative agent of attack is stress (AF associated with adrenergic activity). In others, AF usually begins during relax or sleep (AF associated with vagal nerve dominance). This study aimed to investigate the individual factors associated with the adrenergic or vagal type of AF. This study included 138 patients with paroxysmal atrial fibrillation (AF). Sixty-eight patients reported that AF was frequently triggered by stress (sympathetic-type AF) and 70 patients reported that AF usually began during relaxation or sleep (vagal-type AF). Gender, age, ejection fraction, and temperament were compared across the two groups. Temperament was evaluated using the Formal Characteristics of Behaviour-Temperament Inventory. The groups differed only in temperament. Patients with sympathetic-type AF had a higher score for emotional reactivity (p = 0.002) and perseverance (p = 0.002) temperament traits and a lower score for endurance (p = 0.003) than patients with vagal-type AF and than the average in population.