From the Guidelines
Corticosteroids can exacerbate atrial fibrillation (A-fib) in patients with certain risk factors, such as bronchial asthma, COPD, rheumatic, allergic diseases, or hemoblastoses, as evidenced by a recent narrative review published in 2024 1.
Key Points to Consider
- The relationship between corticosteroids and A-fib is complex and may involve multiple factors, including changes in cardiac autonomic tone, atrial electrophysiological and structural remodeling, and the presence of underlying cardiovascular disease or other comorbidities.
- According to the study, patients with certain conditions, such as bronchial asthma, COPD, rheumatic, allergic diseases, or hemoblastoses, may be at higher risk of developing A-fib when treated with corticosteroids 1.
- The study highlights the importance of reviewing the pharmacological history of patients with new-onset A-fib to identify potential drug-induced causes, including corticosteroids 1.
Clinical Implications
- Clinicians should be aware of the potential risk of A-fib exacerbation when prescribing corticosteroids to patients with certain risk factors, and consider alternative treatments or closer monitoring of cardiac function and electrolytes.
- Regular monitoring of electrolytes, blood pressure, and heart rhythm is crucial during steroid therapy, especially for patients with cardiac risk factors.
- The use of corticosteroids should be tailored to the individual patient's needs, with the goal of minimizing the risk of A-fib exacerbation while still achieving the desired therapeutic effect.
From the Research
Corticosteroids and Atrial Fibrillation
- There are no research papers provided that directly investigate the relationship between corticosteroids (steroids) and atrial fibrillation (a-fib) to assist in answering this question.
- The provided studies focus on the use of beta-blockers 2, 3, exercise-based cardiac rehabilitation 4, and antiarrhythmic drugs 5, 6 in the management of atrial fibrillation, but do not mention corticosteroids.
- Therefore, it is not possible to determine the effect of corticosteroids on atrial fibrillation based on the provided evidence.