A-FIB FACTS: The New Epidemic in Cardiovascular Disease.1


Atrial Fibrillation (A-Fib) is the most common cardiac arrhythmia (abnormal heart rhythm) seen by physicians. It is one of the most under treated heart rhythm disorders in America and accounts for about one-third of hospital admissions.
2

What is Atrial Fibrillation?

  • A-Fib is a serious heart disease in which the upper chambers (atria) of the heart beat out of rhythm with the lower chambers (ventricles) of the heart. This causes the heart to race in an irregular and often rapid pattern, as fast as 300 to 600 times per minute (normal adult rate is 60–100 beats per minute).
  • Since A-Fib causes inefficient pumping of the heart, the disease can lead to other heart rhythm problems. When left untreated, AFib patients have a five times higher chance of stroke, and greater risk of heart failure.2
  • A-Fib is often dismissed as a nuisance arrhythmia because it is not immediately life threatening. Although atrial fibrillation itself usually isn't life-threatening, it sometimes requires emergency treatment. It can lead to complications.
  • A-Fib (or AF) is easily diagnosed by a combination of taking the patient’s pulse and by a simple test called an electrocardiogram (ECG or EKG).

What are the symptoms of Atrial Fibrillation?

  • Symptoms can include pounding or fluttering in the chest (palpitations), shortness of breath, weakness, chest pain, fatigue, dizziness or fainting.
  • Episodes of atrial fibrillation can come and go, or may be chronic; and can range from mild to severe. Some A-Fib patients feel no symptoms at all.

How many patients suffer from A-Fib?

  • At least 2.2 million Americans have atrial fibrillation.3
  • It’s estimated that up to 460,000 new cases are diagnosed in the US per year.4
  • Worldwide, there are about 600 million cases of Atrial Fibrillation.5

Who gets Atrial Fibrillation?
  • Anyone can get A-Fib. But the older one becomes the more likely A-Fib is to develop. A-Fib affects about 1 in 25 people aged 60 and older, and 1 in 10 people aged 80 and older.3
  • Persons over the age of 40 have a 1 in 4 lifetime risk of developing atrial fibrillation.6

What causes A-Fib?

  • In many patients, there is no apparent cause for A-Fib.
  • In others, A-Fib may be related to coronary artery disease (CAD), thyroid disease, high blood pressure (hypertension), structural defects of the heart and its valves, lung disease or other medical conditions.

What are the risks associated with A-Fib?

  • Serious consequences include stroke, permanent heart damage, heart attack, heart failure and death.
  • The morality rate is about double that of patients with normal sinus rhythm;2
  • A-Fib contributes to more than 80,000 deaths annually.4
  • A-Fib related stroke accounts for 15% to 20% of all strokes, i.e., about 75,000 a year.7 A-Fib strokes are more severe and disabling than non A-Fib-related strokes.8,9
  • Remodeling: A-Fib can damage and weaken the heart over time. Electrical “remodeling” can change the shape and size of the heart. The heart becomes less efficient at pumping blood, making it work harder and harder over time. Heart remodeling is progressive and can become permanent.
  • Dementia:  A-Fib patients are 44% more likely to develop dementia; Younger A-Fib patients are at higher risk of developing dementia, particularly Alzheimer’s.10

How is A-Fib treated?


There are a number of short-term and long-term treatments aimed at controlling or eliminating the abnormal heart rhythm associated with A-Fib.
  • Medication for A-Fib patients is designed to regain and maintain normal heart rhythm, control the heart rate (pulse), and prevent stroke. While medication has been considered the first-line treatment for A-Fib, research indicates that half of all patients with symptomatic disease fail drug therapy.3
  • Cardioversion delivers small, timed electrical shocks to the heart to restore normal rhythms.
  • Radiofrequency (RF) Catheter Ablation and Cryoablation are minimally invasive catheter procedures that block electrical signals which trigger erratic heart rhythms. RF Catheter Ablation is the most common curative treatment worldwide for all types of A-Fib. Cryoablation is the newest treatment.
  • Pacemakers may be implanted for pacing support, or in conjunction with Ablation of the AV Node.
  • Surgery, traditionally open-heart, is more commonly performed today concurrent with other heart disease treatments, or stand-alone as a surgical ablation through small port-size incisions in the chest.

What is the impact of Atrial Fibrillation?

  • Treating A-Fib patients costs the U.S. $26 billion annually.4
  • Patients with A-Fib often find the normal activities of daily life become increasingly difficult. Because A-Fib is a progressive condition, the patient’s quality of life often deteriorates.2

Journalists, reviewers, bloggers and educators: You have our permission to post any of our informational documents, in whole or in part, as well as our photos and graphics on your website, blog, or in your print publication. We do ask that you include our website address and/or a link back to the Beat Your A-Fib website (www.BeatYourA-Fib.com)


ADDITIONAL RESOURCES ABOUT ATRIAL FIBRILLATION


  • Atrial Fibrillation Association-US, branch of UK non-profit organization raising awareness of A-Fib; site includes patient education; For Definitions and Abbreviations: http://www.atrialfibrillation-us.org/patient-information/definitions-and-abbreviations.
  • Heart Rhythm Society, world-wide association of cardiac arrhythmia professionals (cardiologists/electrophysiologists), patient education and advocacy; www.HRSonline.org.
  • Atrial Fibrillation: Resources for Patients, since 2002, non-profit site by former A-Fib patient, Steve S. Ryan, PhD, patient education; www.AFib.com.

REFERENCES


1 Gonzalez, A. (July 07, 2011). Atrial fibrillation is emerging as the new epidemic. Cardiac Rhythm News. Retrieved August 23, 2011, from
http://www.cxvascular.com/crn-latest-news/cardiac-rhythm-news---latest-news/atrial-fibrillation-is-emerging-as-the-new-epidemic.

2 Fuster, V., Rydén, L. E., Cannom, D. S., et al. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial Fibrillation—Executive summary. Circulation , 114 (7), 700-752.
http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177031

3 Go, A.S, Hylek, E.M, Phillips, K. A, et al. (2001) Prevalence of diagnosed atrial fibrillation in adults. National implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors In Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-2375. URL
http://dx.doi.org/10.1001/jama.285.18.2370

4 Kim, M. H., Johnston, S. S., Chu, B.-C., et al. (2011). Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circulation: Cardiovascular Quality and Outcomes . URL
http://dx.doi.org/10.1161/CIRCOUTCOMES.110.958165

5 Camm, A. J., Kirchhof, P., & Lip, G. Y. H. (2010). Guidelines for the management of atrial fibrillation. European Heart Journal , 31 (19), 2369-2429. URL
http://dx.doi.org/10.1093/eurheartj/ehq278

6 Lloyd-Jones,  D.M, Wang TJ, Leip E, et al. Lifetime risk for development of atrial fibrillation. Circulation. 2004;110:1042-1046. URL
http://dx.doi.org/10.1161/01.CIR.0000140263.20897.42

7 Hart, R.G, Pearce, L.A, Rothbart, R.M, et al. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators. J Am Coll Cardiol. 2000;35:183-187. URL
http://view.ncbi.nlm.nih.gov/pubmed/10636278

8 Lin, H.J, Wolf, P.A, Kelly-Hayes, M, et al. Stroke severity in atrial fibrillation: the Framingham study. Stroke 1996;27:1760-4. URL
http://view.ncbi.nlm.nih.gov/pubmed/8841325

9 Kelly-Hayes M, et al. The influence of gender and age on disability following ischemic stroke: The Framingham Study. J Stroke Carebrovasc Dis 2003; 12:119-26. URL
http://dx.doi.org/10.1016/S1052-3057(03)00042-9

10 Bunch, T. Jared, and et al. "Atrial Fibrillation Is Independently Associated with Senile, Vascular, and Alzheimer's Dementia." Web. 1 Aug. 2011. URL
http://dx.doi.org/10.1016/j.hrthm.2009.12.004
       

Journalists, reviewers, bloggers and educators: You have our permission to post any of our informational documents, in whole or in part, as well as our photos and graphics on your website, blog, or in your print publication. We do ask that you include our website address and/or a link back to the Beat Your A-Fib website (www.BeatYourA-Fib.com).

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