- Researchers are reporting that people with atrial fibrillation have an average of five additional medical conditions.
- Those conditions include high blood pressure, coronary artery disease, and chronic kidney disease.
- In response, the researchers have unveiled a new software tool to help in the diagnosis and treatment of people with atrial fibrillation.
A new software tool is being developed to help in the diagnosis and treatment of older adults with atrial fibrillation and other medical conditions.
The project is being coordinated by the European Society of Cardiology and the European Heart Rhythm Association (EHRA). The goal is to streamline the evaluation of people with atrial fibrillation.
“This is the cornerstone of the overall aim of the project, which is to improve outcomes of patients with atrial fibrillation by systematic detection and management of underlying conditions, and by multidisciplinary referral or collaboration where needed,” said Hein Heidbuchel, a professor at University Hospital Antwerp in Belgium and scientific coordinator of the project, said in a press release.
The software was unveiled in a report at the annual EHRA conference in Barcelona, Spain, this week.
In their paper, the researchers identified 22 co-morbidities that can impact people with atrial fibrillation. From there, they developed pathways that enable physicians to look for or exclude a certain comorbidity as well as offer a guide for further evaluation and management.
The team then created a software tool that can be used by healthcare providers to evaluate those with atrial fibrillation in a systematic way.
The software will shortly undergo a clinical trial and be tested in 65 hospitals across Europe.
“Our vision is that EHRA-PATHS will demonstrate through its clinical trial that a systematic approach to co-morbidities, based on a software tool with interdependent care pathways, leads to better multidisciplinary management of patients with atrial fibrillation,” said Heidbuchel. “If the project succeeds, it will have delivered a tool to the medical community to improve atrial fibrillation management, and to make it more uniform all over Europe and beyond.”
The risks with other conditions
The research released this week involved interviews with people with atrial fibrillation who say they need better integrated care for the management of their co-existing conditions.
Experts say this is one of the challenges of treating people with atrial fibrillation.
“A lot of medicine is getting very siloed, so it really puts a lot of pressure on the primary care physician to be the quarterback or to be the captain of the team and guide these things. If you look in the U.S., the average patient sees a cardiologist once a year for seven minutes. So, how do we get patients treated for these complex diseases in an efficient way?” Dr. Shephal Doshi, a cardiac electrophysiologist and director of cardiac electrophysiology and pacing at Providence Saint John’s Health Center in California who was not involved in the research, told Medical News Today.
The researchers noted that people with atrial fibrillation have an average of five co-existing medical conditions.
High blood pressure, heart failure, coronary artery disease, obesity, and chronic kidney disease are the most common co-morbidities for people with atrial fibrillation.
“These conditions are all associated with an increased risk of developing atrial fibrillation,” Dr. Paul Wang, the director of the Stanford Cardiac Arrhythmia Service in California who was not involved in the research, told Medical News Today.
“Most commonly these other conditions occur first and atrial fibrillation occurs later. Many of these conditions also increase the risk of stroke with atrial fibrillation,” he added.
What is atrial fibrillation?
Atrial fibrillation is also known as AF or Afib. It is the most common type of heart rhythm disorder.
People with atrial fibrillation have an irregular heart beat in the heart’s upper chambers. The irregularity may cause the heart to beat too slowly, too quickly, or irregularly.
The Centers for Disease Control and Prevention (CDC) estimates that by 2030 more than 12 million people in the United States will have atrial fibrillation.
Risk of atrial fibrillation increases with age.
“Afib is generally thought of as a disease of aging. There’s some common conditions that are seen with older people, such as high blood pressure, such as diabetes, such as coronary artery disease… some of those diseases also put stress on the atrium, that’s a specific chamber in the heart,” said Doshi.
“Atrial fibrillation is an electrical short circuit in the upper chamber of the heart. So things that would put stress on the upper chamber of the heart, that cause the upper chamber to get dilated, to stretch, like high blood pressure, for example, can also lead to atrial fibrillation. So there’s a lot of commonality between some of these disease processes in that the way it affects the heart,” he added.
Afib death rate rising
According to the CDC, the death rate from atrial fibrillation as either the primary or contributing cause of death has been rising for more than 20 years.
Having co-existing medical conditions can impact survival for those living with atrial fibrillation.
“Each of these diseases kind of little by little chip away at the health of the heart and sometimes the heart chips away at the health with some of these other organs,” Doshi said.
“So if you have congestive heart failure, your heart’s not pumping well, it’s not going to deliver as much blood to the kidneys, which could affect the kidneys, or to the lungs, or to the rest of your body. It’s all kind of interrelated,” he added.
How to manage Afib
Lifestyle modifications are one of the options for managing atrial fibrillation risk factors.
However, the new research reported that while many people with Afib were eager to make adjustments to their lifestyle, they lacked the necessary education to implement and maintain helpful changes.
“Lifestyle interventions that benefit atrial fibrillation also benefit overall cardiovascular care. These include management of high blood pressure and diabetes, weight reduction, and increased physical activity,” Wang said.
“There are major challenges in both educating patients as well as helping them with lifestyle modifications. This requires significant financial resources and personnel which may be lacking at many care delivery locations,” he added.
While the management of atrial fibrillation can become complicated in older age due to the presence of other co-morbidities, experts say it can still be done.
“Afib is not a fatal diagnosis. We have such new innovative treatments for patients to maintain their quality of life, improve their quality of life, the key is getting to the right Afib specialists,” Doshi said.
“As you get to your 70s, 80s, 90s, the number of co-morbidities are going to increase,” he added. “It’s very rare that you meet an 80-year-old that’s only on one medication, or none. They’ve usually got multiple things going on. So, the management of these diseases becomes very complicated. The number one thing is obviously treating all of these and giving access to health care should improve patient’s quality of life, and if done in the right way, probably improve their survival.”
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