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Palpitations, getting tired easily, dizziness, fainting? It could be atrial fibrillation (AF), the most common type of cardiac arrhythmia, the risk of which increases with age. If neglected, it lowers the quality of life and increases the risk of stroke five times!
Irregular runout …
MP is the most common type of arrhythmia and one of the leading causes of strokes. It is estimated that over half a million people live with it in Poland. With age, the risk increases – the latest epidemiological studies show that dangerous arrhythmia affects every fifth person over 65!
Usually, AF occurs in people who have suffered damage to the heart muscle in the course of chronic diseases such as hypertension, ischemic heart disease, heart failure, diabetes, valvular disease or obesity. Over the years, these diseases damage the cells responsible for generating and conducting electrical impulses in the heart, which promotes the development of arrhythmias.
But that’s not all … – an attack of MP may be caused by electrolyte disturbances (lowering the concentration of potassium and / or magnesium in the blood), an episode of myocardial ischemia, as well as disorders not directly related to the cardiovascular system, such as hyperthyroidism or chronic kidney disease.
Moreover, AF may appear in people who smoke cigarettes, abuse stimulants such as alcohol, caffeine, stimulants, drugs, or practice endurance disciplines. No wonder MP seizures are most frequent at the weekend. There are also studies showing a higher risk of the disorder in people working more than 55 hours a week and on night shifts.
Sometimes it cakes, sometimes it doesn’t
Although the most common symptoms of AF are palpitations, rapid irregular heartbeat, chest discomfort or pain, dizziness and fainting, sweating, dyspnoea, fatigue, and decreased exercise capacity, some patients experience asymptomatic disease. It happens that MP is only detected during routine tests, such as heart rate measurement or ECG. Sometimes its first symptom is a stroke. How does it happen?
In the course of MP, the normal blood flow inside the heart is disrupted. Turbulence is conducive to the formation of blood clots, the so-called thrombus. The thrombus “pushed” by the heart into the blood vessels becomes an embolic material (plug) that travels with the bloodstream until it hits a vessel of small diameter. In the case of blood clots in the left atrial appendage, such a vessel is an artery in the brain – its closure means a stroke.
It is estimated that almost 30 percent. ischemic strokes are the result of untreated AF. However, the bad news does not end there … The course of stroke in patients with AF is usually more severe and results in significant functional impairment (paresis, speech disorders). Half of those who develop a complication of AF die within the first year after it occurs. On the other hand, those who survive are three times more likely to have a repeat stroke and more likely to become disabled.
In many patients, especially in the initial stage, arrhythmia may be completely asymptomatic, which does not mean that there is no risk of a stroke. In extreme forms, the symptoms of atrial fibrillation are so severe that they prevent normal existence, says Prof. dr hab. n. med. Przemysław Mitkowski, President of the Polish Society of Cardiology.
In addition to stroke, complications of AF include other thromboembolic complications, including transient cerebral ischemia, peripheral arterial embolism, splenic embolism, and mesenteric artery embolism (acute intestinal ischemia). The most common type of arrhythmia can also lead to heart failure, caused by overworking of the heart muscle.
You can work with MP!
Fortunately, as cardiologists argue, MP can be controlled and effectively treated by pushing away the specter of complications. Hence, early diagnosis is so important.
Restoring a normal heart rhythm, what doctors define as “sinus rhythm”, is called “cardioversion.” The procedure can be performed with medications (pharmacological cardioversion) or electrical impulses that are properly synchronized with the patient’s ECG (electrical cardioversion). In some cases, invasive treatment is used, i.e. ablation, which consists in destroying the cells that generate the abnormal heart rhythm or destroying the abnormal connection that conducts impulses.
Due to the risk of thromboembolic complications, many patients with AF require the chronic use of anticoagulants. However, classic oral anticoagulants (warfarin, acenocoumarol) are inconvenient to use – they require frequent monitoring of blood coagulation parameters and adjustment of the dose of the drug.
New generation oral anticoagulants (NOACs) have been available on the Polish market for several years. They have many advantages – they do not require monitoring of blood clotting parameters, are safer and more convenient to use (given in a fixed dose), and they interact less frequently with other medications. Most importantly, they better protect the patient with AF against thromboembolic complications.
New anticoagulants used in prophylaxis in patients with atrial fibrillation are, on the one hand, greater effectiveness in preventing strokes, better safety due to a lower bleeding risk, but also, and perhaps most importantly for patients, greater comfort of treatment due to the fact that when using these drugs, there is no need for frequent biochemical measurements of blood coagulation – prof. dr hab. n. med. Marcin Grabowski, Spokesman of the Polish Society of Cardiology.
Listen to the rhythm
How much does a cardiologist have in common with a violin maker, and the heart with a musical instrument? More than we think, as evidenced by the latest project of the educational campaign “In the rhythm of arrhythmia. STOP IMPACT “. In the educational video “PLAYING IN THE RHYTHM OF THE HEART” Dr. hab. n. med. Paweł Balsam from the XNUMXst Department and Clinic of Cardiology of the Medical University of Warsaw and bassist and drummer Peter Somos use words and sounds to draw attention to the problem of atrial fibrillation (MP).
The name of the project is not accidental – our heart beats in time. When idle, it works regularly at a rhythm of 60 to 80 beats per minute. The sinus node, which generates electrical impulses, is responsible for the proper functioning of the heart. They are conducted through the stimulus-conducting system leading to contractions of the heart muscle.
It can be said that the heart is our “inner drummer”, playing one of the most important roles in the team, which is the human body. When we are healthy, the heart rhythm is steady, even, and it fits perfectly into the game of other organs. Then we feel that everything harmonizes perfectly with each other. However, if we feel slowing down, accelerating, pausing, and then accelerating again, these may be symptoms of MP. In such a situation, it is necessary to see a doctor as soon as possible – early diagnosis of AF and starting treatment may prevent strokes in the patient – comments the cardiologist.
The latest installment of the campaign “In the rhythm of arrhythmia. STOP IMPACT ”also draws attention to the importance of MP prophylaxis. Remaining in the terminology of the video clip, what matters is how we treat our “internal instrument”, whether we listen to its sound, and when it “sounds incorrectly” we remember that his best friend is a luthier, a cardiologist.
We can reduce the risk of MP by leading a healthy lifestyle: by maintaining a healthy body weight, eating healthy, not smoking, limiting the consumption of alcohol and caffeine, and by regular physical activity. In turn, people who have already been diagnosed with arrhythmia should take the doctor’s recommendations to heart, take the prescribed medications regularly and remember about systematic health checks – appeals Dr. Paweł Balsam, MD, PhD.