BOSTON—When at rest, the average person’s heart beats between 50 and 100 times a minute. But sometimes the mechanisms that regulate the heart’s rate and rhythm go awry, leading to irregular heartbeats called arrhythmias. The most common is type is atrial fibrillation (AF), a fast and irregular heartbeat. According to the November 2011 Harvard Men’s Health Watch, AF is becoming more common. Treatment can help, and doctors continue to develop new options for people who don’t do well with the standard treatments.
The consequences of AF are enormous. AF increases the risk of stroke fivefold and almost doubles the risk of premature death. It can lead to heart failure and angina. And each year it accounts for 400,000 hospital admissions, 5 million office visits, and health care costs of over $6.5 billion.
Although the cause of AF isn’t fully understood, there are clear risk factors. Age is an important factor; AF affects nearly 8% of men between 65 and 74 and almost 12% between 75 and 84. AF occurs about 50% more frequently in men than in women. Heredity also plays a role — a third of all people with AF have a family history of the disorder. Other physical conditions that can increase the risk of AF are cardiovascular conditions, lung disorders, and an overactive thyroid. Smoking, excessive alcohol consumption (particularly binge drinking), and anger and hostility (in men) all boost the risk of AF.
Standard approaches to atrial fibrillation include rate control and rhythm control. Various medications can be used to slow the racing heart (rate control). It is also possible to restore a regular rhythm with the use of medications or a small, brief electrical shock. Anticlotting drugs to help prevent stroke are also an important part of treatment.
When these treatments don’t work, a new procedure called radiofrequency ablation may help. It destroys a tiny amount of tissue in the heart to stop it from sending out the abnormal electrical signals that trigger AF. And doctors continue to develop specialized treatments such as special pacemakers and even surgery (the Cox maze and “mini-maze” operations). Cutting-edge therapies can help the relatively small number of people who don’t respond to traditional therapies. But for most people with AF, the most important step of all is to use anticlotting medications to prevent stroke — and here, too, new medications promise to make therapy safer and more effective than ever.
Read the full-length article: “Atrial fibrillation: Common, serious, treatable”
Also in this issue:
- Polymyalgia rheumatica
- Penile shortening post-prostatectomy
The Harvard Men’s Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $29 per year. Subscribe at www.health.harvard.edu/mens or by calling 877-649-9457 (toll-free).
