Every now and then, especially in old age, put your finger on your wrist and record the number of beats. If you hit 100 per minute, talk to your doctor. Even if you don’t have any complaints, you may be suffering from atrial fibrillation. And maybe you may need targeted treatment, as this condition makes it easier for blood clots to form which, moving along the arteries, can increase the risk of a stroke. The problem is that often those who suffer from the most common arrhythmia, especially after the age of 50, do not know they have it. Although perhaps it has elements that increase the possibility of developing it such as overweight.
Heart door
Atrial fibrillation, an “oversized” waistline signals risk
at Federico Mereta
To help these people in the future, a chip to be inserted under the skin could be useful, capable of identifying the “vagaries” of the electrical activity of the heart and therefore of putting on those who live in terms of prevention. To define this opportunity is a research appeared on Journal of American Medical Association (Jama) coordinated by scholars from Massachusetts General and Northwestern Feinberg University School of Medicine. The STROKE AF study examined just under 500 people divided into two groups, followed for then a year: in one cohort the detector was implanted under the skin, in the other one was only checked by external electrocardiograms. In those who had had the subcutaneous “detector” implanted, atrial fibrillation was discovered in 12.1% of patients, compared to 1.8% observed through common monitoring. All this despite the episodes of rhythm disturbance were not particularly short, lasting over an hour. But in all cases the patients did not notice what was happening in their heart. The data is extremely important for cases of cryptogenic stroke, i.e. without a proven cause: thanks to this technology, in the future, it could be possible to develop a targeted treatment on coagulation even in subjects at risk, but without symptoms of atrial fibrillation.
If the heart fibrils, there is a higher risk of dementia
Cardiac arrhythmia is characterized by the irregular electrical activation of the atria, two of the four heart chambers. In the presence of this anomaly, the normal atrial contractions are replaced by chaotic movements, completely ineffective for the purpose of propelling the blood. In addition, the heartbeat becomes completely irregular. In fact, the control of the heart rhythm is lacking by its natural path marker, called the sinus node, which is instead replaced by other areas of the atria. For this reason the heartbeat is altered, with the atria themselves contracting in an uncoordinated and disorganized way, with the rhythm perceptible on the pulse that becomes irregular and often faster. Over time this situation tends to deteriorate heart function and also the pushing activity of the blood towards the body that the heart muscle normally exercises. An effective atrial contraction is therefore lacking during the arrhythmia. The atrial chambers are practically immobile and gradually dilate. Rapid atrial electrical activity is conducted as usual to the ventricles through the atrioventricular node, which filters and reduces the rate of impulses passing through it. The ventricular rate is however high. The consequences of the loss of the mechanical function of the atrium, and therefore of its contribution to filling the ventricle, vary from subject to subject.
In the absence of organic heart disease, a short-lasting paroxysmal atrial fibrillation, which lasts for a few hours, is generally well tolerated, without any haemodynamic resentment (blood pressure remains normal and the only symptom felt by the subject can be an annoying sense of palpitation). This is why discovering the picture is important in a preventive key.
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