Monday, May 18, 2009


At a recent Heart Rhythm Society meeting in Boston, researchers from Utah presented a paper on the incidence of Atrial Fibrillation ( AF ) and its association with dementia, and Alzheimers. It has been know for a longtime that atrial fibrillation is associated with chronic micro-embolisation to the brain and that patients with AF often get strokes ( the bigger emboli ) or dementia ( the smaller emboli ). These are all consequences of chronic cerebral ischemia from micro and macro-embolism. But the researchers in Utah, led by Dr Jared Bunch, also found that patients with chronic AF also had an increase ( 130% ) risk of Alzheimer's. This association is a bit more difficult to understand. After all Alzheimer's is not strict a cerebro-vascular disorder. It may also have a genetic, infective and inflammatory component. Does this mean that AF is also an inflammatory disorder? as suggested by some studies which showed that ARBs can prevent AF.
Obviously more work needs be done.
AF is a very common arrhythmia, especially in the older age group and has this nasty compliction of strokes. Treatment with anti-coagulants, like warfarin, has been shown to prevent strokes in patients suffering from AF, but this then bring up the issue of side-effects from anti-coagulation with warfarin.
In fact researchers are working feverishly to use radiofrequency ablation as a means of treating AF with some success. More importantly, they are also working hard to see how to prevent AF. This may indeed prove difficult as AF may have a degenerative component and age is a major determinant. But it is also true that healthy cardiac lifestyle, including the prevention and treatment of hypertension, prevention and treatment of diabetes, can also prevent heart disease and AF. I would suggest that we major in this and try to avoid heart disease in our fight against AF and strokes.

No comments: