Atorvastatin triggering AF?

[Kinfusion]

I wonder if anyone has heard of a statin being the actual trigger for AF? I found one article that said that a 61 year old man had developed AF two weeks after being put on Simvastatin, but that was back in 2003 and since then most articles seem to say that statins are beneficial and reduce AF. The reason for my question is that my husband has had a horrible 21 months since having a cardiac event in April 2022. Initially thought to be myocarditis but because of the chance it could have been a MINOCA he was put on 80mg Atorvastatin and aspirin although his arteries were clear. (His cholesterol was very slightly raised at that time). He developed very symptomatic AF a month later (so changed from aspirin to Edoxaban) and has struggled since then with breathlessness and poor exercise tolerance all the time, and frequent AF on any real exertion. A scan eventually showed that it had in fact been a MINOCA back in April. Recently he developed very extreme episodes of diarrhea and general upset gut and a trial off the Atorvastatin was agreed. Five weeks later we cannot believe the difference in him. His exercise tolerance has increased dramatically and he has been tackling some quite strenuous diy tasks that he's been unable to face for a long time. Sorry this has been a long post. I know there's a lot on statins on here but I haven't seen anyone actually make a possible association between AF and statins. Thanks for any information.

[BobD Volunteer]

I stopped taking statins long before I developed AF so in my case not connected.

[Kinfusion in reply to BobD]

Thanks Bob for your reply

[mjames1]

No, but anything is possible. However, more likely that statins will reduce your afib burden, rather than increase it, at least according to some studies. And while the mechanism is unclear, it makes sense because statins are an anti-inflammatory and inflammation can contribute to afib.

Also, statins of course, bring down cholesterol, often mentioned along with blood pressure as one of the controllable factors to help afib. And lastly, there are quite arguably worse things than afib, such as coronary artery disease.

So overall, if you need statins, it makes even more sense to take them if you have afib.

Personally, I have a family history of lifestyle-resistant high cholesterol and heart disease. Currently on the super statin, Crestor.

Jim

[pusillanimous in reply to mjames1]

I have taken a low dose statin (5mg per day) for years before my AF was diagnosed , which was expected as it is familial and myself, 4 sisters and father all have it (in my father's case had it) with no side effects at all - may be the high dose is responsible.

[mjames1 in reply to pusillanimous]

Yes and most have no side effects in trials (compared to placebo) even on normal doses.

Jim

[mary70 in reply to mjames1]

I've been diagnosed with atrial fibrillation-yet, in no sense would I agree to take statins ad lib.

[CDreamer]

Glad it helped him. I will never take a statin, not just because of AF but I have a condition which statins are known to cause and exacerbate, there were recent warnings about this. One man’s meat……..another’s poison.

[JackyMac in reply to CDreamer]

That's a new line of thought for me. Didn't occur to me that statins may cause AF. I've been permanent since May and been told that's it. I'm stuck with it and signed off from cardiologists. I think I'll discuss a period without statins with the Dr and see what she says.

[CDreamer in reply to JackyMac]

I’m not sure it does cause AF, the warning was about it causing Myasthenia, which I have, hence there is no way I would ever take a statin as it is known to exacerbate the condition - as does every other heart drug.

[Kinfusion in reply to JackyMac]

It could be just a complete coincidence in my husband’s case, and he might just be having a good spell with AF coming back. He’s going to go on a lower dose of a different statin because they do give a lot of protection for the heart.

[CDreamer in reply to Kinfusion]

My understanding is that they act as an anti-inflammatory, which may be helpful for some people but not me.

[secondtry]

Great, if it works stick with it!

I was pressurised to take statins 20+ years ago as my cholesterol has always been around 7. I turned down the offer. I note now that more and more information coming out from independent medics about the drawbacks of statins and less concern about high cholesterol....could this be another case of 'over caution' by most doctors.

PS My wife takes statins after a minor stroke and her energy is much reduced but she is happy following this protocol.

[Ppiman]

Unfortunately, from what I can read, the standard therapy for your hubby’s coronary illness is a statin plus an ACE inhibitor. I gather AF can occur following any cardiac event, so it might not be statin related, but given the improvement, it is looking likely.

If the improvement continues and let’s hope so, then some alternative treatment will need to be found for the coronary illness, I guess.

Steve

[Mike11]

If you've had a cardiac event AF most likely will follow. Might take a day, might take a few years, but once the heart is damaged it's to be expected in due course.

[Coco51]

When I took my first dose of Atorvastatin aged 60, I'd had episodes of palpitations - which i now know were undiagnosed AF - several times in the previous 4 years. So I can't say the Atorvastatin caused my AF.

But that night I woke with tachycardia. which took a while to stop. Coincidence? No way of knowing. AF is pretty random even when you know your triggers, so I might have had it that night anyway. However I was so nervous about taking a statin that my nerves may have played a part!

Anyway I went to the GP and she said that it was always worth trying a different form of medication as they all have slightly different pathways. We ended up with Pravastatin and that's been OK.

I've read Ben Goldacre and many others about the down side of statins. But the main objection seems to be the mass prescribing when some people won't benefit. Personally my family history is dire - I have high BP, father died of stroke aged 48, mother massive fatal heart attack at 72. Grandmother with heart failure etc etc - so I've made the decision to take the medications which they did not benefit from. Who knows if it's right. We all have to decide based on our own reading of the research and our own reactions.

If your husband is better off without Atorvastatin then he obviously has a bad reaction to it. But might be worth trying another if doctors think he'd benefit.

[Villador]

strange you should say this. When I think back my PAF problem started after starting on Atovastatin 40mg.

Does this ring an alarm bell with anyone else too ?

[Kinfusion]

Thanks for all the replies. My husband is going to try a low dose of a different statin. There may have been no causal link between Atorvastatin and AF and it does seem wise to have some statin protection.