THE ATRIAL FIBRILLATION EPIDEMIC

Find out diseases & conditions associated with atrial fibrillation

Anageing population and our western lifestyle are ensuring that the prevalence of a common medical condition, atrial fibrillation (AF), is increasing at such a rate that it is predicted to be the next cardiac epidemic. It affects 30 million sufferers worldwide, and:

• kills three times as many people as car accidents each year in the western world.

• the cost per person is greater than that for cardiovascular disease and osteoarthritis, and it is twice that of obesity.

• affects one percent of the population and over 15% of individuals over 80 years of age.

• the cost to society is in the billions of dollars.

Several significant AF facts are:

• Many people do not know they have atrial fibrillation since it can be silent or asymptomatic (no symptoms). It can be overt or symptomatic, in which the patient experiences symptoms which can range from debilitating to inconvenient.

• While both men and women suffer from AF, women run a higher risk of complications, including death.

• The prevalence of AF increases with age, yet it can be found in teenagers.

• Successful treatment is life-long, highly personalised taking patience and perseverance to establish and maintain.

Atrial fibrillation is an arrythmia caused by a malfunction of the heart’s electrical system that affects the pumping function of the heart. Apart from the severity of the symptoms, the biggest concern around AF is the risk of a stroke. The use of blood thinners to mitigate the stroke risk must be balanced by the risk of bleeding.

Diseases & conditions that are associated with atrial fibrillation.

In coming to a better understanding of atrial fibrillation, it is valuable to understand AF associations. These are the factors that lend weight to the possibility of AF being present, but they are not the mechanisms that give rise to the actual problem.

1. AF associations found within the heart structure are:

• high blood pressure, micro scarring, general wear, and tear

• problems with the valves, abnormality of the muscle

• cardiac failure (including congenital heart problems).

2. Other external associations that can affect AF are: • age, obesity & diabetes

• obstructive sleep apnoea • chronic renal disease, toxins such as alcohol • pulmonary thrombi embolism • genetic disposition, thyroid problems • infections and inflammation • emotional stress, surgery, endurance training.

The important association that cannot be controlled is age. However, the other most important factors, that can be modified are: • obesity • high blood pressure • alcohol consumption.

These associations all cause strain on the body and particularly the heart. AF can be a common final pathway of stress within the body. However, being aware of problems that can be associated with AF is a really an important first step towards avoidance, or management of the condition.

Practical points to managing AF: 1. If you have AF then, evaluate and

manage other diseases. Visit your doctor for a thorough health check of blood pressure, diabetes, coronary disease, and renal disease since these are common travelling companions of AF and these should be evaluated and managed.

2. If you do not have AF, early control could delay or prevent its onset. See your doctor for a thorough health check. Hypertension, diabetes, coronary disease, and renal disease are common travelling companions of AF, especially as you age.

3. Look after yourself, particularly if you carry too much weight.

4. If you snore, then lose weight, and if you still snore, see your doctor. 5. Alter your habits with alcohol consumption.

If you drink more than two or three standard alcoholic drinks a day (male) or more than two (female) then, double the price of the wine that you drink and halve what you consume.

In summary, atrial fibrillation is a common and increasingly prevalent heart condition. Thus: 1. Simple lifestyle maintenance can substantially reduce your risk of developing the condition. 2. If you already have AF, attention to good management with the help of your medical practitioner can considerably improve your symptoms and the quality of your daily living, and for some, can provide lengthy symptom-free living. 3. Regular health checks are advisable.

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.