Emelia J. Benjamin is a renowned Professor of Medicine and Epidemiology at Boston University and a cardiologist at Boston Medical Center. She discusses the rising prevalence of atrial fibrillation (AF) and its link to serious health risks. The conversation highlights how smartwatches can detect AF, though traditional monitoring remains essential. Emelia emphasizes the importance of managing lifestyle factors like alcohol and obesity in treating AF, along with the need for comprehensive healthcare access to improve outcomes for patients.
The rising incidence of atrial fibrillation is largely attributed to aging populations and lifestyle factors like obesity and smoking.
Early diagnosis and comprehensive treatment strategies, including anticoagulation and lifestyle changes, are essential to prevent severe complications associated with atrial fibrillation.
Deep dives
Understanding Atrial Fibrillation
Atrial fibrillation is characterized by irregular heart rhythms resulting from electrical and structural changes in the heart's atria. The condition can arise from several factors, including ectopic atrial premature beats and autonomic dysfunction, particularly in cases like sleep apnea. Studies show that its incidence is rising, driven by an aging population and improved survival rates for cardiovascular diseases. Risk factors such as age, obesity, hypertension, and lifestyle choices like smoking and alcohol consumption significantly increase the likelihood of developing this arrhythmia.
Diagnosis and Detection Challenges
Atrial fibrillation often goes undiagnosed since it can be asymptomatic in 10 to 40 percent of cases. For those who do experience symptoms, it may manifest as palpitations or shortness of breath. Wearable devices, such as smartwatches, have shown varying accuracy in detecting atrial fibrillation, highlighting the need for confirmation through clinical methods like 12-lead ECGs. Consequently, many patients may only receive a diagnosis after experiencing serious complications such as heart failure or stroke.
Management and Treatment Considerations
Early identification and management of atrial fibrillation are crucial for preventing severe complications like stroke and heart failure. A comprehensive treatment strategy often includes oral anticoagulation to reduce stroke risk, with various approaches for rhythm control, such as medication or ablation for eligible patients. Additionally, lifestyle modifications—especially reducing alcohol intake—are recommended for individuals at risk. The conversation around treatment should engage patients in shared decision-making to address individual health concerns while following updated guidelines.
The number of people living with atrial fibrillation (AF) is increasing, and they have a higher rate of cardiovascular events, chronic kidney disease, and dementia compared with people without AF. Emelia J. Benjamin, MD, ScM, an epidemiologist and cardiologist, discusses current diagnosis and treatment of AF with JAMA Deputy Editor Mary McGrae McDermott, MD. Related Content: