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Is An Atrial Fibrillation Epidemic On The Way?

By Michael Lasalandra
Beth Israel Deaconess Medical Center Correspondent

Atrial fibrillation, a type of irregular heartbeat that can lead to heart failure and stroke, is reaching epidemic proportions in the U.S.

A study from the Mayo Clinic, published in 2006, estimated that 5.1 million Americans suffer from atrial fibrillation, a rhythm abnormality in which the heart's upper chambers quiver rather than beat regularly and effectively. Previously, it had been estimated that just 2.2 million Americans suffered from the condition.

"Atrial fibrillation is a major public health problem that needs urgent attention," said Dr. Teresa S.M. Tsang, senior author of the study and associate professor oat the Mayo Clinic College of Medicine.

The study, reported in Circulation: Journal of the American Heart Association, said cases are rising at an alarming rate and said atrial fibrillation may affect nearly 16 million Americans by the year 2050.

In a separate paper published in 2004, Dr. Jonathan S. Steinberg of St. Luke's-Roosevelt Hospital Center in New York, said the rising incidence of AF is due in part to an aging general population and to increased longevity resulting from improved medical care among patients with coronary artery disease, hypertension and heart failure -- all chronic conditions that predispose people to AF.

Others say that stress may also be contributing to the epidemic, particularly when it afflicts younger people. Obesity and sleep apnea are also considered factors in the growing AF epidemic.

"AF is clinically important because it contributes to the incidence of heart failure, stroke and both overall and cardiovascular mortality," Steinberg said. "Equally troubling are the potential financial burdens associated with this chronic and increasingly common condition."

AF is being diagnosed more today because of better technology, according to Dr. Charles Haffajee, a cardiac electrophysiologist and director of device trials and the electrophysiology network at the  CardioVascular Institute at Beth Israel Deaconess Medical Center.

"We're diagnosing it more today than 10 years ago," he said. "Years ago, people may have had it, but we couldn't diagnose it. AF comes and goes, but there was no way to measure it. When you saw the patient, they may not have been experiencing AF at that moment."

Now, if a person has palpitations, he or she can come in and be equipped with a home monitor, he noted. The monitor can help determine if AF is occurring.

At the same time, Haffajee said, people are living longer, and have more time to develop AF. "All of our technologies and interventions have allowed patients to live longer," he said. "As a result, atrial fibrillation has become an extremely common disease. It's a big problem."

Before the diagnostic capability improved, people would often suffer a stroke and then find out they had AF. Now, it is more likely they will be diagnosed with AF and put on medications to prevent stroke from occurring, he said.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted February 2010

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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