AUTHOR=Gottlieb Lisa A. , Blanco Lorena Sanchez y , Hocini Mélèze , Dekker Lukas R. C. , Coronel Ruben 

TITLE=Self-Reported Onset of Paroxysmal Atrial Fibrillation Is Related to Sleeping Body Position

JOURNAL=Frontiers in Physiology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.708650

DOI=10.3389/fphys.2021.708650

ISSN=1664-042X

ABSTRACT=<p><bold>Background:</bold> Because stretch of the atrial myocardium is proarrhythmic for atrial fibrillation (AF) and a left lateral body position increases atrial dimensions in humans, we hypothesized that left lateral recumbence is a frequent AF-triggering body position in AF patients.</p><p><bold>Methods:</bold> We performed a questionnaire study of symptomatic paroxysmal AF (episodes of AF &lt; 1 week) patients scheduled for a first AF ablation therapy at Catharina Hospital, Eindhoven, the Netherlands and at University Hospital, Bordeaux, France.</p><p><bold>Results:</bold> Ninety-four symptomatic paroxysmal AF patients were included [mean age 61 ± 11 years, median AF history of 29(48) months, 31% were females]. Twenty-two percent of patients reported a specific body position as a trigger of their AF symptoms. The triggering body position was left lateral position in 57% of cases, supine position in 33%, right lateral position in 10%, and prone position in 5% (<italic>p</italic> = 0.003 overall difference in prevalence). Patients with positional AF had a higher body mass index compared to patients without nocturnal/positional AF [28.7(4.2) and 25.4(5.2) kg/m<sup>2</sup>, respectively, <italic>p</italic> = 0.025], but otherwise resembled these patients.</p><p><bold>Conclusion:</bold> Body position, and the left lateral position, in particular, is a common trigger of AF in symptomatic AF patients. Moreover, positional AF is associated with overweight. Understanding of the underlying mechanisms of positional AF can contribute to AF treatment and prevention.</p>