Monday, May 08, 2006

Atrial Fibrillation and Height

Atrial fibrillation is probably the most common arrhythmia in the elderly. It is interesting to note that tall prople and people with large body surface area, are also more proned to atrial fibrillation. Dr Ibrahim Hanna (Emory University) published his findings in the April 18th 2006 issue of the Journal of the Amrican College of Cardiology. It is difficult to induce A Fib in mice, but horses go into A Fib easily. Hanna had looked into the ADVACENT registry data of 25, 268 pts, with a mean age of 66yrs old and the mean LVEF was 31%. 72% of these patients had Ischemic Cardiomyopathy. The ADVACENT registry is a prospective, longitudinal, multicenter registry. The results from the registry is summarised in the table.

For every 16 cm increase in height, there is a 50% increase incidence of atrial fibrillation. It is interesting to theorise the reason for the increase. Could it be that taller patients have larger atrial walls and so allow more circus motion. I am more inclined to think that this study is severely skewed by the fact that 72% of the patients had ischemic cardiomyopathy. Did mocardial ischemia or poor LV contributed more to the A Fib? However, when we next see tall patients with poor LV, perhaps it is good to consider prophylaxis against A Fib.? Or does inflammation have something to do with this. Are these patients better helped with "statins"?

1 comment:

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