What is Atrial Fibrillation (Afib)
Atrial Fibrillation (AF) is an irregular heartbeat (arrhythmia) caused by rapid and disorganized electrical signals sent from the sinoatrial (SA) node to the atria (upper heart chamber) which causes it to contract at irregular intervals. This often results in a heartbeat of 300-600 beats per minute while the average adult heart beat is around 60-100 beats per minute.1 When this happens the atria is unable to fully empty and the heart can not pump as much blood as the body requires.
The incomplete ejection of blood from the atria results in less oxygen and nutrients supplied to muscles and can result in shortness of breath, anxiety, chest pains, weakness, sweating, difficulty exercising, dizziness or fainting. Most problematic of all is the harmful blood clots that can form due to blood pooling in the atria. These blood clots then have the potential to travel to small arteries in the brain which could result in a stroke.6
The increased risk of blood clots forming in patients with Atrial Fibrillation results in them being five to seven times more likely to have a stroke than people with a regular heart beat.6 In fact, AF related blood clots account for 15 to 20 percent of ischemic strokes, where a clot blocks an artery or vein and prevents the blood flow to the brain. Patients with chronic AF are often prescribed Coumadin or warfarin to prevent harmful blood clots form forming.2
In 2008 Medicare approved a way for patients with AF to help decrease their risk of developing blood clots and strokes by testing their INR more frequently from home. This was published in Medicare’s, “Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management”, and supports frequent INR testing from home using a portable FDA approved INR monitor.7 In fact frequent home testing compared to monthly INR testing results in better warfarin management, which consequently results in less bleeding episodes and reduced incident of stroke.8
Who is Affected ?
Atrial Fibrillation is the most common sustained heart rhythm disorder and affects approximately 4 percent of all people over 60 years of age and close to 10 percent that are over 80 years old.5 Approximately 3 million adults in the United States have been diagnosed with Atrial Fibrillation and the prevalence of AF is expected to increase to about 8-12 million over the next 30 to 40 years.1,2,3
Atrial Fibrillation increases the risk for heart disease and stroke, which are both leading causes of death in the United States.1 As a result, each year over 460,000 patients with Atrial Fibrillation are admitted to the hospital and AF contributes to 80,000 deaths annually.5
Easily check your risk of Atrial Fibrillation HERE.
How is it Diagnosed ?
AF may be related to high blood pressure, have no known cause, be related to thyroid disease, lung disease, structural defects of the heart and its valves, coronary heart disease or other disorders. Atrial Fibrillation is diagnosed by a Holter or Event monitor that is worn to monitor a patient’s heart rhythms over time or by a Electrocardiogram (ECG).6 Most people that have acute AF develop chronic Atrial Fibrillation.5
For more info on Atrial Fibrillation:
1. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial ﬁbrillation and ﬂutter in the United States. Am J Cardiol.2009;104:1534-1539.
2. Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart Disease and Stroke Statistics—2010 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2010;121:e1-e170.Accessed August 15, 2012.
3. Naccarelli GV, Johnston SS, Dalal M, Lin J, Patel PP.Rates and Implications for Hospitalization of Patients>65 Years ofAge With Atrial Fibrillation/Flutter.Am J Cardiol. 2012;109:543-549.
4. Kim MH, Johnston SS, Chu BC, Dalal MR, Schulman KL. Estimation of total incremental health care costs in patients with atrial ﬁbrillation in the United States.Circ Cardiovasc Qual Outcomes 2011;4:313–320.25.
5. Lafuente-Lafuente C, Mah I, Extramiana F. Management of atrial fibrillation. BMJ. 2009;b5216.
6. “Atrial Fibrillation” 2013. retrieved December 18th 2013, from Cleveland Clinic Web site: https://my.clevelandclinic.org/heart/atrial_fibrillation/afib.aspx
7. Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management (CAG-00087R), March 2008, 1-17.
8. Heneghan C., et al. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis.The Lancet. 2006. 367, 404-411.