Friday, July 21, 2006

Growing Epidemic of Atrial Fibrillation

A recent paper, coming out of the Mayo Clinic, published in the online version of Circulation, July 3, 2006, found an increasing incidence of AF among adults in Olmsted county. The incidence from 1980 - 2000 increase 12%.

AF is a treatable condition, but it also carries with it the dreaded, devastating complication of stroke. The cause of this increasing incidence is not obvious from the study, althought the usual factors of hypertension, diabetes, poor LV function, valvular dysfunction, were all contributory. The new factoe gaining importance, even in AF causation, is obesity. This increasing incidence of AF seemed to be in parallel with an increasing incidence of obesity. Obesity, comes with it an enlarged LA and depressed LV function.

There are however some of us who believe that AF is an inflammatory disease, much like atherosclerosis, and diabetes. Perhaps we can use statins to prevent it. I am certain that ARBs like Valsartan is able to prevent AF, whether this is because of Valsartan's anti-inflammatory effect, or diabetes preventing effect, is not obvious to me. But one thing is certain. AF is becoming more common, and so is obesity. We need to work hard to prevent obesity, and in so doing, probably AF too. Then there is always Valsartan, and statins.

1 comment:

Jan said...

My own personal observation is that there is a lot of undiagnosed obstructive sleep apnea (OSA) in the obese. OSA could also explain some of the increased incidence of AF.

All of the patients that I have referred for sleep studies have had significant OSA. This suggests that I am not referring enough patients for evaluation.
From what I recall, CPAP does not change mortality, but does affect quality of life. Would be an interesting study to prospectively study pt's w/ OSA and follow those who use their CPAP routinely vs. those who don't and see if there is a difference in AF rates.