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Prognosis

Program: Catheter Ablation for Atrial Fibrillation: Heart Rhythm Control Without Medicines
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Andrew Schorr:

Now, as you discuss this it sounds kind of chronic, but could it be a potentially fatal condition? 

Dr. Knight:

It’s rare that atrial fibrillation is lethal, but it really has a big impact on quality of life, and most of our therapies and treatment options we offer patients are geared toward making them feel better rather than trying to make them live longer. 

There is another important aspect to this that we haven’t talked about that’s beyond symptoms and mortality, and that’s stroke.  Atrial fibrillation, when I described the atrium fibrillating like kind of a bag of worms, when they don’t contract like that the atrium can form clots, and if that clot leaves the left atrium, leaves the heart and goes to the brain, that can cause a stroke.  So stroke is a real concern when there’s patients who may not be diagnosed with atrial fibrillation who could develop a stroke.

Andrew Schorr:

So it’s not something you want to ignore. 

Dr. Knight:

No, definitely not something you want to ignore.  Even if you’re not symptomatic from it, it still needs to be addressed.

Andrew Schorr:

Now, could it go along with other conditions?  Like you mentioned heart failure, could there be other things going on altogether? 

Dr. Knight:

Yeah, there are young patients who have what we call lone atrial fibrillation who have no other problems with their heart, but patients who develop atrial fibrillation tend to have something else wrong with their heart.  They often will have high blood pressure or hypertensive heart disease.  They might have valvular heart disease.  They might have had rheumatic heart disease in the past.  There are patients who you talked earlier about clots and plaque rupture and coronary disease.  Well, patients who have had heart attacks who can develop congestive heart failure also are at risk for developing atrial fibrillation.  So I’d say high blood pressure and coronary disease are common causes of atrial fibrillation in addition to just the aging process that occurs to the heart.

Andrew Schorr:

Does it run in families at all? 

Dr. Knight:

It’s rare.  There is evidence that if you have a first-degree relative with atrial fibrillation you’re slightly more likely to develop it, and there are some genetic syndromes, but in general this is more caused by environmental factors and acquired over time.

Andrew Schorr:

So to diagnose it typically somebody could listen to your heart.  EKG can confirm it. 

Dr. Knight:

That’s right.

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