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Atrial fibrillation's not just for the old. New research finds more cases in younger people

Anapa, Russia - February 16, 2019: A woman's hand with an Apple Watch Series 4 with the ECG app on the screen. Dr. Le thinks wearable devices now picking up more diseases than before contributed to the increased cases of AFib.
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A woman's hand with an Apple Watch Series 4 with the ECG app on the screen. Dr. Le thinks wearable devices now picking up more diseases than before contributed to the increased cases of AFib.

 

Atrial fibrillation occurs when the upper heart chamber beats very fast and chaotic and causes an irregular heartbeat. The condition is common to people 65 and older.

But new research on 67,000 people found increasing cases of AFib in younger people.

Dr. Brian Le, a clinical cardiac electrophysiologist with Texas Health Dallas, explained to KERA’s Sam Baker why the findings did not surprise him.

I think that with wearable technologies being so accurate these days we're able to pick up more diseases that could have been there before, and we just never monitored those younger patients. So now they present to us saying, "Hey, my heart's out of rhythm, or I see irregular heart rhythm on my monitor. What do you think is going on?" I think that's one possibility.

The other possibility is probably due to lifestyle. Younger people now are vaping, more smoking, drinking energy drinks, increasing obesity, which leads to sleep apnea and diabetes, the high blood pressure.

I think all of these factors can increase the risk of having to fit in much younger patients.

Are you seeing this in your own practice?

I am, and usually we can identify some risk factors that they have.

There's one unusual case where we have super healthy people who do extreme endurance sports, like running marathons and doing triathlons and spartan workouts. They developed Afib at a very young age due to something called vagal mediated, equal fibrillation triggers. They're more the exception to the rule.

Usually, it's that people tend to be obese with diabetes, high blood pressure, and they have obstructive sleep apnea. Then when you look at their lifestyle, they consume more alcohol, more caffeine, more energy drinks, and more decongestants. And they may be on A.D.D. medications. That would play a big role in the development of atrial fibrillation.

Is atrial fibrillation treatable?

The way that we would treat Afib is:

  • Number one, start out with changes in lifestyle. You have to identify all the potential risk factors of atrial fibrillation:
  • If you're obese, we have to lose the weight.
  • If you have sleep apnea, we have to find a way to treat it. Weight loss is a big component of that.
  • Control the diabetes, control the blood pressure,
  • Get off of all the different, exotic things that can increase your AFib, like caffeine, energy drinks.
  • If you can get off the medication, get off of those things.
  • And then we can progress to either medication, antiarrhythmic drugs, or ablation therapy that can help to control the AFib.

    Explain the ablation procedure.

A catheter is placed from the femoral vein up into the heart. We can apply different energy sources to the areas inside the pulmonary vein triggering atrial fibrillation, which we try to ablate outside the vein to prevent the trigger from entering the heart.
What about a cure for Afib?

I would say that Afib is never a cure, because getting older is a cause of a fit, and we haven't found a cure for getting older, so that risk factor remains. But the more gracefully we grow older, the better we will do. And that's why I tell my patients you must grow old gracefully.

Growing old gracefully?

We're fighting Father Time. I call Afib a disease of the privileged. You lived long enough. You put up with all the wear and tear of life. Now it's time to deal with the consequences of being older.

We have to exercise more. We have to have a pristine diet. We have to do all the things that we can to keep our body and our mind better to fight atrial fibrillation. And then we have to accept Father Time. He will eventually win, but we can put up a good fight to try and keep our bodies healthy.

So AFib is avoidable?

It can be, but there's also a genetic component. You may do everything perfectly in life. But as we age and age based on our genetics, you may develop AFib. Even though you've done everything perfectly: You have no diseases. Your body mass index is pristine. Yet, you can still get it. That's just the fact that the heart wears down.

RESOURCES:

What is atrial fibrillation?
 
Afib Study

Why Are Younger Adults Developing This Common Heart Condition?

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.