Can asthma cause an irregular heartbeat?

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A recent study by Cepelis and colleagues investigated a potential association between asthma and atrial fibrillation, which is a condition characterized by an irregular heartbeat.

Atrial fibrillation is a common heart problem characterized by an irregular heartbeat. Studies have shown that irregular heartbeats are associated with an increased risk of blood clots, stroke, and worsened cardiovascular outcomes.

In 2014 Chan and colleagues demonstrated that atrial fibrillation may be associated with asthma, a seemingly unrelated medical condition. Asthma is a long-term inflammatory disease that narrows the airway and makes breathing difficult. Besides this initial study in 2014, there had been no other studies investigating the link between asthma and irregular heartbeats in a larger sample of individuals, until now.

In a recent study, published in JAMA Cardiology, Cepelis and colleagues investigated the association between asthma and the risk of developing AF using data of 54,567 participants from the Nord-Trøndelag Health Study (HUNT). The study found that following adjustments for confounding factors, including sex and age, participants with asthma had a higher risk of developing atrial fibrillation, compared with non-asthmatic patients.

Furthermore, the study found that patients who had their asthma under control were at a slightly lower risk of having atrial fibrillation when compared to patients with uncontrolled asthma. Collectively, in consensus with Chan and colleagues, the current study suggests that asthma may be a risk factor for atrial fibrillation.

Previous studies have already established that asthma can increase the risk of stroke and adverse cardiovascular outcomes. However, for the first time, the two studies by Cepelis and Chan have shown that asthma may also increase the risk of developing atrial fibrillation. Moreover, the study demonstrated that the better management of asthma is associated with lower risk of developing atrial fibrillation, compared to patients with poor asthma management.

Although the current authors propose that the association between asthma and an irregular heartbeat may be explained by common inflammatory pathways between the two medical conditions, more research is warranted to better understand and characterize this relationship.

Written by Haisam Shah, BSc

Reference: Cepelis, A., Brumpton, B. M., Malmo, V., Laugsand, L. E., Loennechen, J. P., Ellekjær, H., … & Strand, L. B. (2018). Associations of Asthma and Asthma Control With Atrial Fibrillation Risk: Results From the Nord-Trøndelag Health Study (HUNT). JAMA cardiology.

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