Published September 19, 2011
Anne B. Curtis, MD, Charles and Mary Bauer Professor and Chair of the Department of Medicine, is the Buffalo area spokesperson for AF Awareness Month, the Heart Rhythm Society’s national campaign to raise awareness about atrial fibrillation.
Since the beginning of September, Curtis has been speaking about the symptoms of, and risk factors for, atrial fibrillation, a condition that affects more than two million Americans.
Because AF can increase the risk of stroke by 500 percent, it’s critical to know what it is and whether you’re at risk for it, says Curtis, a past president of the Heart Rhythm Society.
“Atrial fibrillation is a rapid and irregular heart rhythm that can cause the heart to beat erratically, sometimes as fast as 200 beats per minute.
“It’s the most common heart arrhythmia but, unfortunately, most people know very little about it.”
Curtis says that many people are diagnosed with AF after visiting their doctor with complaints of palpitations, shortness of breath, fatigue or exercise intolerance.
“But some patients have AF and don’t have any symptoms,” she notes, “which is why it’s critical to know who is at higher risk for it. For one thing, AF becomes more common as we get older. Anyone older than 60 years of age is automatically at higher risk for developing AF.”
Other risk factors include diabetes, hypertension, congestive heart failure or other types of cardiovascular disease as well as hyperthyroidism, chronic lung disease, sleep apnea, excessive alcohol consumption and serious illness or infection.
Anyone who has one of these conditions should discuss atrial fibrillation with their physician to see if an electrocardiogram should be performed.
If a diagnosis of AF is confirmed, individuals can be treated with medications, which prevent stroke, slow the heart rate and keep the rhythm normal.
In addition to warfarin—the well-established anti-stroke medication that requires blood testing to adjust the dose—Curtis says that certain people with AF now have another alternative for stroke prevention: the anticoagulant dabigatran.
Additional medications are now being tested, which may soon provide further options.
Recurring bouts of AF also can be treated with catheter ablation, a procedure that involves threading catheters up into the heart to the locations, usually in the pulmonary veins, where the atrial fibrillation impulses start, Curtis says.
“We can burn around the openings of those veins, and that prevents those impulses from getting into the heart and triggering AF,” she says.
This procedure can prevent further episodes of AF in certain patients; in others, it helps manage the condition. Patients may experience fewer symptoms or better rhythm control with drugs that didn’t work previously.
Curtis is a key contributor to the guidelines on AF that are issued periodically by the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
These guidelines, based on the most current research findings, help health care providers make the best treatment decisions for their patients.