Department of Emergency Medicine, Kaiser Permanente (KP) Sacramento Medical Center, Sacramento, CA; The Permanente Medical Group, the CREST Network, and the KP Division of Research, Oakland, CA.
Perm J. 2020;24. doi: 10.7812/TPP/19.238.
In this essay I tell the story of insightful patients from around the world with cold-drink atrial arrhythmias, particularly atrial fibrillation (AF). This common condition has received little research attention and remains unknown to many physicians. The under-representation of "cold drink heart" in the literature led me and a colleague a few years ago to publish a case report on this topic in an open-access journal. I included my email address so that physicians and researchers could contact me. Although I sought a physician audience, the report struck a chord with patients. Sixteen individuals have since written me to express their gratitude for having received medical validation of the causal connection they had made between swallowing cold drink or food and their episodes of paroxysmal AF. The validation was all the more important because of their physicians' prevalent disregard of the link, making them miss out on the opportunity to partner with their patients in AF management by trigger avoidance. I explain here how these patients have handled their cold-drink AF and connect their reports with the few published in the literature. These rich email exchanges illustrate how eager patients can be for an explanation of their medical condition and for an opportunity to manage their symptoms. These communications also remind us about the important role patients play in physician education. These email-writing patients have done us all a great service by teaching about the precipitants, prevention, and underrecognition of cold-drink atrial arrhythmias.
在这篇文章中，我讲述了来自世界各地的有识之士患者的故事，他们都患有冷饮性心律失常，尤其是心房颤动（AF）。这种常见病症几乎没有得到研究关注，许多医生对此也知之甚少。由于“冷饮性心脏”在文献中的代表性不足，几年前，我和一位同事在开放获取期刊上发表了一篇关于这个主题的病例报告。我还附上了我的电子邮件地址，以便医生和研究人员可以与我联系。尽管我希望医生能够看到这篇报告，但它却引起了患者的共鸣。此后，有 16 个人给我写信，对我确认了他们在饮用冷饮或食物与阵发性 AF 发作之间建立的因果关系表示感谢。这种确认非常重要，因为他们的医生普遍无视这种联系，使他们错过了通过避免触发因素来与患者一起管理 AF 的机会。我在这里解释了这些患者如何处理他们的冷饮性 AF，并将他们的报告与文献中发表的少数报告联系起来。这些丰富的电子邮件交流说明了患者是多么渴望了解自己的病情，并希望有机会控制自己的症状。这些交流也提醒我们，患者在医生教育中扮演着重要的角色。这些写信给我的患者通过讲述冷饮性心律失常的诱因、预防和认识不足，为我们所有人提供了很好的服务。
