Is it true or not that you are in your late thirties, feeling weak and asking why you have a whimsical heartbeat? You might want to get it checked out. For, atrial fibrillation or A-Fib disease — an irregular and often very rapid heart rhythm — which was usually found in patients who are 65 years and above is now striking younger patients. Doctors say the A-Fib cases among younger adults are because of lifestyle-related stress, hypertension, and obesity.
More than 67,000 patients treated for A-fib disease there, nearly a quarter were younger than 65. The younger ones were at increased risk of death compared to those without the condition. And most often, they were diagnosed with other A-Fib risk factors like high blood pressure, obesity and sleep apnea, which could worsen their health.
A similar trend has been noticed here. “According to hospital-based registries and studies in India, A-Fib is increasingly affecting young people in their late thirties and forties.”
EXPLAINING A-FIB:-
A-Fib occurs when the heart’s upper chambers (atria) contract irregularly and incoherently with the heart’s chambers (ventricles). This can result in impaired blood circulation, a heightened risk of blood clots, stroke, heart failure, and other cardiovascular complications.
The most common cause of atrial fibrillation among the younger lot in India is rheumatic heart disease, which affects multiple heart valves. “But among patients without any heart valve issues, A-Fib happens because of hypertension, cardiomyopathies (heart chamber dilation and reduced contractility), increased thyroid hormone levels, obstructive sleep apnea, diabetes, obesity, and chronic kidney disease. The most common social cause for this is binge drinking (also known as ‘Holiday Heart Syndrome’),” pointing out that another cause can be congenital conditions like atrial septal defects.
HIGH BP INCREASE RISK:-
The clinical-etiological spectrum of non-valvular A-Fib among less than 40 years — those less than 40 years — with data from 117 patients attending the cardiac OPD at a tertiary care hospital in eastern India over a period of two years. Significant contributors to non-valvular A-Fib among adults were hypertension (40%) and left ventricular systolic dysfunction (31%) stating, “Hypertensive patients carry a 14% additional risk of developing atrial fibrillation.”
A-Fib patients have a three-to-five fold increase risk of stroke. Long-standing A-Fib with a very fast heart rate may cause a reduction in heart muscle contraction and even heart failure. “The younger the person is, the worse it becomes as A-Fib can greatly impact daily activities like walking, and exercise, often resulting in breathing difficulties and decreased quality of life.”
HOW TO TACKLE IT:-
The main advice, apart from continuing with the medicine, was to keep weight under control and do lots of cardio exercises like walking.
As a major risk factor is obesity, reduction of body weight is an important treatment. Another is a complete change in lifestyle among the young, with focus on a healthy diet, good sleep and exercise. “Early detection and management in younger individuals can significantly reduce risk of complications later in life.”
Apart from conventional risk factors, all young patients with A-Fib should be assessed for heart valve defects. “They should also be checked for thyroid disorders and obstructive sleep apnea. Obesity should be managed, and alcohol restricted. The patient should not neglect intermittent episodes and take a cardiology opinion as early as possible.”
HOW TO DIAGNOSE AND TREAT:-
Blood tests can initially show any abnormalities that might influence heart function. An ECG provides insights into rhythm irregularities. Portable Holter monitors and event recorders are used to monitor heart activity over a period, capturing intermittent arrhythmias. Implantable loop recorders offer continuous monitoring to detect sporadic episodes of A-Fib. Stress tests evaluate heart performance during physical activity, while chest X-rays provide more information about the heart and lungs. These diagnostic tools collectively help in accurately diagnosing A-Fib and deciding suitable treatment.
An effective therapy for atrial fibrillation is ablation. Ablation is a procedure that uses small burns, or even freezes heart cells to cause scarring inside the heart that helps break up or insulate the electrical signals that cause erratic heartbeats.
Even patients in their twenties and thirties being referred to the clinic. “With increasing awareness of the importance of rhythm control and reluctance to be on potentially lifelong medications, such patients usually prefer to undergo A-Fib ablation with excellent outcomes.”
WHO IS AT RISK?:-
- Those with pre-existing heart disease, diabetes, and high BP.
- Those with obstructive sleep apnea as they struggle to get enough rest.
- There is also a correlation between alcohol consumption, vaping, and A-Fib.
- Extreme endurance exercises like marathons and triathlons also linked to higher risk.
