If your pulse races or appears slow, talk to your doctor. And don’t hesitate to check it out. Because with this simple attention you could “catch” atrial fibrillation, the most common form of arrhythmia which can increase the risk of up to five times stroke. And opportunistic screening, with an occasional evaluation while in the doctor’s office, can be a key prevention strategy.
This is revealed by the results of the European AFFECT-EU project. All people at risk should be tested for atrial fibrillation every time they attend a doctor’s appointment. In particular, the invitation is basic for those with a particular risk profile. In addition to people who suffer from heart failure or have already had a stroke, heart rhythm control is strongly recommended in those who are elderly, obese, hypertensive and in those with particularly high N-terminal blood values. pro B-type natriuretic peptide (NT-proBNP), a test commonly used to monitor heart failure.
Second Renate Schnabel from University Hospital Hamburg-Eppendorf, project coordinator, “screening for atrial fibrillation can identify undiagnosed atrial fibrillation so that the condition can be managed according to guidelines, including starting anticoagulant drugs to prevent stroke”.
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An often hidden arrhythmia
Atrial fibrillation is the most common heart rhythm disorder in the world. And the trend appears to be growing: estimates say that the number of people over 55 with arrhythmia in the EU will go from the 8.8 million observed in 2010 to 17.9 million by 2060. The problem is that often the arrhythmia it is not perceived. And therefore it is not diagnosed until a stroke occurs.
The four-year EU-funded AFFECT-EU project saw a consortium of 26 partners, including the European Society of Cardiology (ESC) presenting the research in a note, work to define a feasible atrial fibrillation screening strategy for healthcare systems across Europe, with the aim of preventing stroke and premature death. First data to emerge: screening is effective, according to a meta-analysis of 35,836 participants.
But be careful. There is a long way to go. Because it still seems far away, considering that the analysis shows that early diagnosis strategies of this type are completely absent in 11 EU countries analyzed and that the majority of arrhythmia cases were identified in subjects who presented symptoms.
Second Daniel Englerfrom the same German hospital, “people with atrial fibrillation are more likely to be severely disabled or to die from stroke or heart failure than those without arrhythmia. This makes prevention an imperative to reduce morbidity and maintain high quality of life”.
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Screening works
Arriving early with the diagnosis of this pathology means reducing the risk of experiencing acerebral ischemia because with medical treatments the blood is made more fluid and the chances of clots forming inside the heart that block the arteries that supply the brain are lowered. All this, with savings on healthcare costs.
This is confirmed by a study recently published in European Heart Journal, conducted by Swedish experts from Linköping University and the Karolinska Institute. The analysis is based on the results of the study StrokeStopappeared on The Lancet in 2021. The research was coordinated by experts from the Karolinska Institute and represents the largest clinical observatory on arrhythmia, with 30,000 subjects between 75 and 76 years of age analysed. In the study, subjects in one group were offered the opportunity to participate in screening, while the other group acted as a control group. The results of this early diagnosis approach have been satisfactory.
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What happens in those who suffer from atrial fibrillation
If the arrhythmia is present, the ventricular frequency, the one we perceive through the heartbeats wrist, can vary widely. The subjective disturbance is greater if the number of beats per minute is very low or very high. In these cases the patient may feel fatigue, shortness of breath during efforts and, in exceptional cases, may lose consciousness. There are people who do not have these disorders, but only have a subjective sensation of palpitation: they feel the heartbeat in an annoying way, like a beating of wings in the chest. However, if your heart beats are neither too slow nor too fast, you may not feel any discomfort. And this is why screening is important.
In almost one in three cases this condition is not recognized in time and puts the heart, but above all the brain, at risk. Also because brain injuries in the case of atrial fibrillation are on average more serious and therefore potentially fatal. Thanks to screening, in the future it will be possible to recognize those with arrhythmia and implement, in addition to specific treatments aimed at the rhythm disturbance, therapies to thin the blood, reducing the risk of clots forming and therefore potential emboli that move towards the arteries that supply the brain.
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