Last month, during World Heart Rhythm Week, a research study published in the EP Europace, a journal of the European Society of Cardiology (ESC), called for urgent action to prevent, detect and treat atrial fibrillation to stop a substantial rise in disabling strokes.
According to the researchers, atrial fibrillation also called AFib or AF, is the most common heart rhythm disorder and accounts for .28 percent to 2.6 percent of healthcare spending in European countries. They note that patients experiencing a quivering or irregular heartbeat (arrhythmia) have a five times higher risk of stroke and that 20 percent to 30 percent of strokes are caused by cardiac condition. Strokes due to atrial fibrillation are more disabling and more often fatal than strokes with other causes.
Risk of Strokes Increase for Seniors with Atrial Fibrillation
The researchers estimate that 7.6 million people over 65 in the European Union (EU) had atrial fibrillation in 2016 and this is expected to increase by 89 percent to 14.4 million by 2060. They predict that prevalence is set to rise by 2 percent, from 7.8 percent 9.5 percent and that the proportion of these patients who are over 80 will rise from 51 percent to 65 percent.
“Atrial fibrillation patients over 80 have even greater risks of stroke so this shift in demography has enormous implications for the EU,” said study author Dr. Antonio Di Carlo, of the Italian National Research Council, Florence, Italy, in a statement released last month. “Older patients also have more comorbidities linked to atrial fibrillation such as heart failure and cognitive impairment,” says Di Carlo.
Prevention of atrial fibrillation is the same as for other cardiovascular conditions, say the researchers, noting that this includes not smoking, exercise, a healthy diet, keeping alcohol under moderation, and finally controlling blood pressure and diabetes.
Screening for atrial fibrillation is important because oral anticoagulation effectively prevents strokes in these patients, says Di Carlo, and that general practitioners (GP) should opportunistically screen for atrial fibrillation by performing pulse palpation during every consultation. Patients with an irregular pulse would have an electrocardiogram (ECG) for confirmation. “The majority of older people see their GP at least once a year, so this is an efficient and effective method to diagnose atrial fibrillation and prevent complications,” he said.
Teach Patients about Symptoms Atrial Fibrillation
The researchers suggest that GPs can tell patients about AF’s symptoms such as palpitations, racing or irregular pulse, shortness of breath, tiredness, chest pain and dizziness. And they can teach patients how to check for an irregular pulse using the fingertips, which can be reported and followed-up with an ECG. “I recommend this approach for now,” said Dr Di Carlo, noting that “In future there may be reliable devices for first line screening by the public such as smartwatch apps, but these technologies are not ready for widespread use.”
The researchers calculated the numbers of atrial fibrillation patients over age 65 projected in the EU in the next four decades, by first measuring the prevalence in a representative sample of people over 65 in Italy. They then used population projections from the statistical office of the EU (Eurostat) for all 28 Member States.
This study was funded by the Italian Ministry of Health, National Center for Disease Prevention and Control.