Atrial fibrillation, also known as AFib, is a common form of abnormal heart rhythm that occurs when the two upper chambers of the heart beat in an irregular fashion.
Around 3.5% of people aged 65-74 years old are affected by this medical condition and it can be lifethreatening if left untreated.
Common treatments for Atrial fibrillation include blood thinners to reduce the risk of stroke and other medications to control arrhythmias.
Atrial fibrillation and stroke
In addition to being diagnosed during a medical examination, atrial fibrillation can also be diagnosed as a result of a stroke, which makes it one of the most common causes of strokes.
A stroke caused by AF is much more serious: one in three people die within 30 days, and one in two within one year. As a result of stagnation of blood in the atria, atrial fibrillation facilitates the formation of clots.
Atrial fibrillation can cause strokes when these clots break off and travel to the brain’s arteries. The risk of stroke is multiplied by five in a patient with atrial fibrillation, depending on other risk factors, such as age, gender, high blood pressure and diabetes.
A number of treatments are available to slow the heart rate and reduce AF, including anticoagulants (antivitamin K or oral anticoagulants). Stroke prevention with aspirin and platelet aggregation inhibitors is rarely prescribed for patients with AF. High blood pressure and other risk factors must be avoided or controlled by people at risk.
The causes of atrial fibrillation
Atrial fibrillation is a condition characterized by an irregular heartbeat caused by chaotic electrical impulses in the atria. It can be caused by high blood pressure, heart attack or valve disorders, thyroid disease, lung disease, diabetes, sleep apnea, alcohol use disorder, and other underlying conditions that can strain or damage the heart’s muscle tissue.
Certain medications or substances can also trigger atrial fibrillation.
Symptoms
The main symptoms are: fatigue, shortness of breath, palpitations with irregular and rapid heartbeats, chest pain, unsteadiness, dizziness, sweating, and nausea. However, some patients are asymptomatic.
The diagnosis
If the patient has rapid, irregular heartbeats, the doctor asks about:
- his medical history;
- his health problems (does he have heart disease, thyroid problems?);
- the frequency of symptoms experienced;
Epidemiology
The number of French people with AF is between 600,000 and 1 million. It is estimated at 350,000 in Canada. The annual incidence is 5/1000 around sixty and 20/1000 after 80 years.
Blood thinners are recommended for people with atrial fibrillation
An updated guide from the American Academy of Neurology recommends that individuals with atrial (or atrial) fibrillation take blood thinners to prevent the risk of stroke.
This particularly concerns those who have already suffered a stroke or a transient brain attack.
The danger of atrial fibrillation (irregular heartbeat) is explained by the fact that the blood stays longer in the atria, which favors the appearance of clots by coagulation phenomenon. The clots can then travel from the heart to the brain. One in 20 people with untreated atrial fibrillation is likely to have a stroke within the next year.
Anticoagulants are medicines that help prevent clots from forming inside the heart and preventing them from traveling to the brain. The newer anticoagulants (dabigatran, rivaroxaban and apixaban) are as (if not more) effective than warfarin, the standard anticoagulant. In addition, the risk of bleeding with warfarin is greater. Source: American Academy of Neurology (AAN).
Atrial fibrillation can accelerate memory problems
Rapid, irregular heartbeats — signs of atrial fibrillation — are quite common in older people, which could trigger early problems with memory and reasoning.
“This means that heart health is an important factor related to brain health. says lead study author E. Thacker (University of Alabama at Birmingham, USA).
More than 5000 elderly people, with no history of atrial fibrillation or stroke, were followed for an average of 7 years. At the same time, they took cognitive tests every year. Of the 5,150 participants, 11% developed atrial fibrillation over the 7 years. The study showed that people with atrial fibrillation had lower scores on cognitive tests (memory, reasoning), compared to those without heart problems .
If these results are confirmed, the next steps will have to determine the cause and the means to prevent this cognitive decline, adds Dr. Thacker.
Source: American Academy of Neurology (AAN). Rapid, irregular heartbeat may be linked to problems with memory and thinking, 2013.