Better Detecting Cardiac Arrhythmia

Atrial Fibrillation may be 'new epidemic' in heart disease

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Atrial Fibrillation is the most common abnormal heart rhythm, affecting about 2.2 million Americans. A report recently submitted suggests that it may in fact emerge as "the new epidemic" in heart disease.

The report presented at the EHRA EUROPACE Conference recently by the German Competence Network on Atrial Fibrillation and the European Heart Rhythm Association suggests that management of the arrhythmia can be achieved through better detection and management of risk factors.

Other suggested steps included good clinical use of new antithrombotic therapies, early detection of any new arrhythmia and timely rhythm control treatment.

"Get checked for an arrhythmia, especially if over the age of 65."

Age is one of the key risk factors for atrial fibrillation, but many other factors can be at play such as genetics, gender, presence of hypertension, diabetes, valve disease, heart failure and coronary artery disease. The report recommends that analysis of several cardiac biomarkers - particularly natriuretic peptides - can help indicate risk of atrial fibrillation.

This is especially true when it comes to diagnosing the disorder in the young, which is often a result of genetics. But the report noted that many risks remain elusive and suggests a need to characterize these factors.

The group also advocated for the use of anticoagulants as a potentially life-saving therapy when it comes to strokes, which those with AF are at a greater risk. About 15 percent of strokes occur in those with atrial fibrillation, according to the American Heart Association. However, their administration comes with a risk of severe bleeding, making it necessary to balance the risk with the outcome.

Vitamin K antagonists, which reduce blood clotting, are traditional treatments, but their use is limited by food interactions, bleeding and monitoring. The newer anticoagulants, such as dabigatran, apixaban or edoxaban, may prevent some of those problems.

Though highly effective in clinical trials, everyday use has not been tested. The report encourages the new therapies, but calls for additional information and caution in using them.

Even with anticoagulant therapy, AF patients may still fare worse than patients with other cardiovascular conditions. The report encourages a comprehensive approach to help improve outcomes, while noting that the residual stroke rate remains unacceptably high at 1.5 percent per year with the newer treatment.

Professor Paulus Kirchhof from the University Hospital Münster in Germany and one of the organizers of EHRA EUROPACE said that management of atrial fibrillation is undergoing "remarkable changes," and that the report provides guidance in good use of the new therapies.

The report has not been published in a peer-reviewed journal at this time.

Reviewed by: 
Review Date: 
June 27, 2011
Last Updated:
June 30, 2011