Health Care

Atrial fibrillation: the danger of an accelerated heart

Two prestigious Brazilian doctors visited our country to talk about atrial fibrillation – a very common cardiac arrhythmia – and the need for people who suffer from it to follow anticoagulant treatment.

A normal heart beats between 60 and 100 times per minute, however, people with atrial fibrillation (AF) experience heartbeats up to 450 times per minute.

Recognized as a complex disease to detect, symptoms such as chest pain, shortness of breath, dizziness, fainting or low blood pressure can alert you to an arrhythmia that causes a part of the heart, the atrium, to disorient your heartbeat and clots are generated in it.

“With FA, the atria lose the contractile force and in this loss the greater formation of clots is propitiated. Then, when they increase, they can leave the atria and go to various regions of the body, “explains Dr. Álvaro Avezum, cardiologist at the U. de Sao Paulo. In this way, when it occurs in the central nervous system, “it leads to a cerebrovascular accident 
(CVA),” warns the specialist.

Without going any further, among the types of existing AF, non-rheumatic has great consequences for patients, increasing twice the risk of death, three times the risk of suffering heart failure and up to five times the risk of stroke. Prevalence, in fact, fatally grows with age and other factors.

“The population that has heart failure, heart disease or high blood pressure increases their chance of having AF. Any person who is of advanced age will also have a higher proportion of developing it. For example, after 80 years, one in four individuals will have atrial fibrillation, “says Dr. Avezum.
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Oral anticoagulation to live

Among the medications that help prevent the formation of blood clots and reduce the risk of stroke in patients with this “accelerated” heart rhythm is an oral anticoagulant called warfarin, used as a treatment since the 1950s, and that the specialists used until it was discovered that it liquefied the blood.

However, this alternative is not as effective and safe as the new generation of oral anticoagulants (ACO). According to Dr. Avezum, “there are four new anticoagulants in current clinical practice. Rates of intracranial bleeding or stroke due to hemorrhage are lower with these agents compared to warfarin. “

The new OACs are recent, but quite effective as a treatment for AF and the reduction of related pathologies.

“They have an impact on the reduction of CVA caused by atrial fibrillation of up to 75%, compared with the untreated one. Considering that these drugs are easy to use and have very few side effects, they are currently considered one of the greatest discoveries of the century, “says Dr. Alexandre Pieri, vascular neurologist and head of the Neurology team at the Albert Einstein Hospital in Brazil.

Despite these advances, Dr. Avezum reveals the great challenge that the region has in this area. “The observational studies show that probably they should not be more than 20%, one in five patients with AF, those who are treated adequately with anticoagulation in South America,” he warns.

Risk factors

Among the most common causes of risk for developing AF are: 
– Being over 60 years old 
– Heart problems such as high blood pressure, coronary artery disease, previous heart attacks, structural heart disease (valvular problems or congenital defects), among others . 
– Diabetes 
– Thyroid disease 
– Abuse of alcohol or stimulants