50-year Trends in Atrial Fibrillation: More A-Fib but Less Stroke
An analysis of 50 years of data from the Framingham Heart Study reveals good news and bad news for A-Fib patients.
Sadly, the number of people with A-Fib has more than quadrupled over the last 50 years!!!
But happily there was a 75% reduction in stroke rate (1998-2007 compared to 1958-1967). And, there was a 25% reduction in mortality after diagnosis of A-Fib.
What This Means to Patients: The Good News
Thanks in large part to warfarin (and the development of catheter ablation procedures), stroke rates over the years have declined by an amazing 75%. (Note: the new anticoagulants weren’t in use until after this study.)
As much bad press as warfarin has received and with all of warfarin’s bad side effects, we have to recognize that warfarin kept a lot of people from having a stroke. For years warfarin was the only game in town. Warfarin saved a lot of lives and disabling strokes.
New Therapies to Stop A-Fib and Prevent Stroke
The authors of this study talk about “therapeutic successes for atrial fibrillation” which have increased survival. Catheter ablation (and surgery) have certainly given A-Fib patients hope of a cure, when before all they could do is live with A-Fib and die from it.
New Anticoagulants (NOACs) Likely to Further Reduce Stroke Rate
The new anticoagulants (NOACs) will likely further reduce the A-Fib stroke rate. Eliquis, in particular, may be a major improvement over warfarin. Eliquis tested better with a better safety record than the other NOACs.
What This Means to Patients: The Bad News
Four times more people are developing A-Fib compared to the last five decades. A-Fib has rightly been called an epidemic. One out of four people over 40 will develop A-Fib in their lifetime. Today 1 out of 10 people over 80 years old has A-Fib.
Silent (no symptoms) A-Fib has emerged as a major killer. Of those who suffer a stroke, 20% later discover that they had silent A-Fib which probably caused their stroke.
The Good, the Bad and the Ugly
But even if all the EPs were perfectly trained and could work 24-hour days 7 days a week, they would barely put a dent in the huge number of new people developing A-Fib.
We may be facing a future where many new A-Fib patients may have to rely on drugs to cope with A-Fib.
But the current record for drug therapy isn’t good. There haven’t been any new antiarrhythmic drugs developed to stop A-Fib (with the possible exception of Tikosyn). Almost all current antiarrhythmic drugs either have bad side effects or aren’t effective for most patients. And if they do work, they often lose their effectiveness over time.
Don’t let this data discourage you. Seek your cure NOW. See an electrophysiologist about treatment options to cure your A-Fib.