ATRIAL FIBRILLATION
AF is increasing quickly & is predicted to be the next cardiac epidemic.
ANageing population and our western lifestyle are ensuring that the prevalence of a common heart problem, atrial fibrillation, is increasing so quickly that it is predicted to be the next cardiac epidemic.
What is Atrial Fibrillation?
It is an irregular heartbeat, often called an arrhythmia, that occurs in the upper chambers of the heart. It is frightening when it happens and often results in an ambulance trip to the hospital. It occurs in 1% of the population and in 15% of people aged 80 and over. So possibly your parents or grandparents have had this condition. It can lead to blood clots, stroke, heart failure and other heartrelated complications.
1. What is the best management approach?
Atrial fibrillation, commonly known as AF, kills three times as many people as car accidents each year in the western world. It is a very large topic and is best explained in this book Atrial Fibrillation
Explained. To understand what I believe is the next cardiac epidemic, I explain:
• what the condition is
• how we diagnose it
• how we manage it and
• how that impacts on the patient.
Several drugs are used in its management and other approaches to treatment. AF is discussed in a way that allows patients to understand the best way to look after the condition and live with it in personal sets of circumstances. I encourage the involvement of the family in any management plan.
Currently there is no medical cure for AF,
thus prevention is the only way to lessen the impact of AF. Please view the short video on AF here.
2. Questions and Concerns
Understandably, there are a lot of practical questions associated with AF. Some are:
• do I need a pacemaker?
• can I be screened for AF?
• do I need to store AF drugs in a particular way? • how often do I need testing or see my cardiologist?
• what effect does caffeine have in relation to AF?
• can I exercise safely?
• what if I need to have surgery?
• can I stop the medications if I feel well? And of course, there is always the question of how do we deal with complicated situations? What if we are dealing with a patient who?
• is elderly, frail and liable to fall?
• has need of a stent in a narrow artery?
• has cardiac failure?
• has severe renal failure?
• has other serious complications?
3. Current Guidelines
In Atrial Fibrillation Explained, these questions are answered in detail. The information is based on current guidelines and is presented using simple language. The book offers precise yet understandable detail with numerous patient histories to help explain this complex and frequently encountered condition.
4. Personalised Management
Despite it being so common, AF does not allow a one-treatment-for-all approach.
I have had elderly patients who remain active and are not frail. Within the setting of routinely looking to anticoagulate patients to reduce the risk of a blood clot forming in the heart and leading to a stroke, anticoagulation (thinning the blood) is a really important component of management.
I had one patient who regularly went into the bush where he used a chainsaw. He had been a logger throughout his life and that was not going to change. So, we considered when deciding on his care:
• the man being 80+ years of age
• in the bush using a chainsaw and other sharp pieces of equipment, and
• a long, long way from help.
• He still went on anticoagulation treatment, but not before a detailed discussion which led him to understand the pros and cons of his situation.
5. Summary
Every day, I see the suffering associated with heart disease. My deep desire in writing the book was to provide information that would help people:
• be informed so that they could have their best chance of a healthy life
• be ahead of the game by reducing their risks, and
• if already AF sufferers, be well informed about giving attention to good management that can considerably improve symptoms and quality of daily living.
Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website.