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Atrial fibrillation is an increasingly common problem. The number of people with this cardiac arrhythmia is constantly increasing. Atrial fibrillation has very dangerous consequences, including heart failure and an increased risk of premature death. This arrhythmia is also associated with the possibility of developing dementia.
- Atrial fibrillation is classified as a heart disorder
- In 2017, up to 42 million people worldwide could have had atrial fibrillation
- Treatment can save a life, provided that a proper diagnosis is made
- Unfortunately, about 30 percent. patients, atrial fibrillation is asymptomatic or mildly symptomatic – says Dr. Adam Sokal from the Department of Cardiology, Congenital Heart Defects and Electrotherapy of the Medical University of Silesia in Katowice
- More current information can be found on the Onet homepage.
Atrial fibrillation increases the risk of dementia
The number of people with AF is steadily increasing. According to the data presented by the specialist, in 2017 there were 32,5 to 42,6 million people worldwide with this cardiac arrhythmia. And it is forecast that the number of people with this disease in Europe alone in 2030 will increase to 14-17 million.
Dr hab. n. med. Adam Sokal from the Department of Cardiology, Congenital Heart Defects and Electrotherapy, Medical University of Silesia in Katowice, warns that atrial fibrillation requires appropriate treatment as it can cause serious complications.
“The presence of atrial fibrillation significantly increases the risk of premature death and circulatory failure, as well as dementia and cognitive deterioration” – noted the specialist. She explains that thromboembolic complications, including ischemic stroke, are the most serious clinical consequence of this cardiac arrhythmia.
“It has been proven that anticoagulant treatment with the use of both traditional drugs (vitamin K antimetabolites: warfarin, acenocoumarol) and modern NOAK drugs (dabigatran, rivaroxabam, apixabam) reduces the risk of stroke in patients with atrial fibrillation” – he argues.
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Anticoagulation therapy in turn increases the risk of bleeding. The specialist emphasizes, however, that even a high risk of bleeding cannot be a reason for discontinuing anticoagulation in a patient with detected atrial fibrillation.
Atrial fibrillation may be asymptomatic
According to the European Society of Cardiology, the diagnosis of this arrhythmia was based on a classical ECG or a Holter ECG of at least 30 seconds, meeting the diagnostic criteria for atrial fibrillation (no repeated P waves and irregular RR intervals).
“In patients with typical symptoms, the implementation of appropriate diagnostic measures, especially if the symptoms are prolonged or frequent, will in most cases lead to the diagnosis of atrial fibrillation, which allows the initiation of appropriate treatment. Unfortunately, about 30 percent. In patients, atrial fibrillation is asymptomatic or mildly symptomatic. This is the so-called Silent Atrial Fibrilltion: SAF »- notes Dr. hab. Adam Sokal.
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For this reason, the European Society of Cardiology recommends performing the so-called opportunistic screening for all patients over 65 years of age; and systematic screening for patients over 75 years of age.
‘Opportunistic screening’ means performing tests for the detection of atrial fibrillation during each contact with a qualified healthcare professional. This means, for example, that a nurse has regularity in the pulse or an ECG is performed by a doctor during an appointment for, for example, treatment of a respiratory infection. On the other hand, “systematic screening” is a large project planned within the health care system, aimed at identifying people with silent atrial fibrillation.
How to recognize atrial fibrillation? There are several possibilities
The specialist claims, however, that the development of medical technology has allowed the introduction of algorithms detecting arrhythmias in a number of devices used by patients in daily medical self-monitoring (pressure measuring devices) or everyday devices such as smartwatches and smartphones or various types of belts or vests. These devices, referred to as “wearables”, are widely available and enable the daily self-monitoring of patients.
“However, it should be remembered that the mere detection of arrhythmias is not the same as the diagnosis of atrial fibrillation” – he emphasizes. He emphasizes that it is extremely important that patients who receive electrocardiographic confirmation of atrial fibrillation as a result of using modern (or traditional – pulse screening) screening tools.
According to the specialist, some devices assessing the regularity of the pulse have an additional possibility of recording 30 s of the ECG in the case of irregularity. They also have the option of pre-processing the ECG signal – so as to give the person performing the recording the information whether he or she should immediately see a doctor in order to make / rule out the diagnosis of atrial fibrillation.
«In addition, there are various types of devices and applications based on cellular technology available on the market, allowing the patient to make an ECG recording by himself and send or save this record for medical evaluation. The presence of this technology is, on the one hand, a chance to avoid unnecessary strokes, but on the other hand, it is a burden for the health care system »- believes Dr. Adam Sokal.
He points out that the diagnosis of atrial fibrillation, resulting in the inclusion of anticoagulants in treatment, requires an individual medical assessment of the ECG record, confirming compliance with the criteria required by the definition of the European Society of Cardiology. (PAP)
Author: Zbigniew Wojtasiński
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