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Although the exact mechanism of atrial fibrillation after European hornet sting is unknown, it may involve vagally mediated shortening of atrial refractoriness, the venom itself, and/or the human catecholamine response to bee stings (2,4).
But available data support the recommendation of the American Academy of Allergy, Asthma, and Immunology that venom Immunotherapy be used for at least 3-5 years in all patients with a history of severe systemic honeybee, wasp, or hornet sting reactions and a positive intradermal venom skin test, speakers agreed in a symposium at the AAAAI's annual meeting.
Hornet stings are more painful than typical wasp stings because of their venom.