A recent study found 1 in 3 patients to have atrial fibrillation during cardiac monitoring who were never previously diagnosed.
The study suggests that many people may unknowingly be at risk for this deadly heart rhythm.
Those with atrial fibrillation are at increased risk for blood clots, stroke, heart failure, and much more.
The study authors looked at data provided by long-term cardiac monitor implants and found close to a third had undetected atrial fibrillation. According to lead researcher, James Reiffel, cardiologist and professor at Columbia University College of Physicians and Surgeons in New York City, “Based on these results, it’s likely there’s probably a lot more undetected atrial fibrillation among seniors.”
In 2014, the same study author published a paper in Am J Med, discussing how atrial fibrillation increases one’s risk of stroke 5-fold.
What’s so significant about a study such as this is the following: If cardiac patients on long term monitors run the risk of this deadly heart rhythm being missed, what about those of us who aren’t continually monitored?
What is Atrial Fibrillation?
Atrial Fibrillation (Afib) is a type of abnormal heart rhythm in which the electrical impulses fail to travel through the heart muscle rhythmically and predictably. Since the heart muscle is a pump, it relies on methodical impulses so it can fill and pump the blood throughout the body properly.
Electrical impulses, in a healthy individual, originate in the SA (sinoatrial node) in the right atrium of the heart. The SA node gauges the rate of the impulses based on the person’s activity. Hence if one is exercising and needs more cardiac output, the SA node will trigger a faster pulse so oxygenated blood is delivered throughout the body quicker.
The electrical activity, once discharged, travels to both upper chambers of the heart (the atria) and then down to the AV node and then to the septum between both lower chambers of the heart (the ventricles).
Image above from PinnacleHealth
The right ventricle pumps blood into the lungs to become oxygenated. This blood travels back to left atrium which pumps it into the left ventricle. The left ventricle then pumps the blood into the aorta which transmits it to smaller vessels throughout the body.
As you can imagine, the pump and its electrical impulses need to work in concert. In atrial fibrillation, however, the SA node isn’t in charge anymore and electrical impulses misfire throughout the atria. This causes a “fibrillation” of the heart muscle where it loses its normal heart beat and beats erratically. The heart pump cannot fill adequately and blood starts to slosh around since its not being pumped out efficiently.
Blood that sits and sloshes around can form clots. These clots can travel once they do finally exit the heart and block blood flow to the lungs (pulmonary embolus) or to the brain (stroke).
What are signs or symptoms of atrial fibrillation?
Patients can often go “in and out” of atrial fibrillation. Many times they won’t notice it at all. However symptomatic afib may cause the following:
Shortness of breath
What are the risk factors for atrial fibrillation?
Although afib can occur at any age, it may become more common as we age.
Moreover those with high blood pressure, heart disease, sleep apnea, COPD, lung disease, diabetes and thyroid issues may be at higher risk as well.
Alcohol use in high quantities can increase one’s risk and energy drinks may trigger an abnormal heart rhythm as well.
How can I get screened for atrial fibrillation?
Firstly, you can discuss your risk factors with your medical provider. Some insurance companies, however, may not always pay for screening.
Secondly, you can get screened and evaluated for stroke risk through Life Line Screening. According to their website, they offer screening packages that not only test for atrial fibrillation but also evaluate for carotid artery disease (of which can also increase risk of stroke), abdominal aortic aneurysm, peripheral vascular disease, and osteoporosis.
I just had my screening at Life Line and it was easy and painless. For me, I didn’t want to wait to have a heart condition before I wore a heart monitor.
The study above was presented in Barcelona, Spain, at the European Society of Cardiology’s annual meeting.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician