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Tag: a-fib

  • Having A-Fib Might Raise Odds for Dementia

    Having A-Fib Might Raise Odds for Dementia

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    By Steven Reinberg 

    HealthDay Reporter

    MONDAY, March 13, 2023 (HealthDay News) — The common irregular heartbeat known as atrial fibrillation (a-fib) may increase the risk of dementia, a new study suggests.

    Researchers found that people newly diagnosed with a-fib had a 13% higher risk of developing dementia, the progressive loss of memory and thinking skills. The risk was even higher (65%) among those who developed a-fib before age 65 and in people who did not have chronic kidney disease (20%).

    “The health consequences of atrial fibrillation may be broader than originally recognized in certain individuals,” said lead researcher Dr. Nisha Bansal, a professor of medicine at the University of Washington, in Seattle. “A personalized approach is needed to help inform patients of the consequences of their atrial fibrillation.”

    A-fib is the most common type of heart arrhythmia (irregular heartbeat), Bansal said.

    “Until now, atrial fibrillation has been strongly linked with the risk of stroke, and the possible link with dementia has been unclear,” she said.

    A-fib is a rapid, disorganized beating of the heart’s upper chamber. Episodes can come and go, or may be persistent. It can lead to blood clots that travel to the brain, causing a stroke.

    This study doesn’t prove that a-fib causes dementia, only that there appears to be a link between the two. Bansal emphasized that not everyone who has a-fib will develop dementia.

    “If atrial fibrillation is also associated with dementia, it has important clinical and public health implications when it comes to the management of patients,” Bansal said. “More research is needed to understand the biological mechanisms that explain this association as well as whether treatment of atrial fibrillation might lower the risk of dementia.”

    For the study, Bansal and her colleagues collected data on nearly 197,000 patients from the Kaiser Permanente health system in California. Half had been recently diagnosed with a-fib. They were compared with a like number without the condition.

    The researchers took steps to offset the influence of other medical conditions known to increase dementia risk. Bansal, a kidney specialist, said it was a surprise to find a greater risk among those without kidney disease and in younger patients.

    Her team will try next to better understand the biological mechanisms linking a-fib and dementia, and how different treatments for irregular heartbeat factor in.

    It’s not known why a-fib might cause dementia, said Dr. Laurence Epstein, system director of electrophysiology at Northwell Health in Manhasset, N.Y., who reviewed the findings.

    “One of the things that we’ve always struggled with is: What is the potential reason a-fib leads to an increased risk of dementia?” he said.

    A lot of people think a-fib may not only affect the heart but blood vessels throughout the body, which might increase the risk of dementia. “It’s a question this study doesn’t answer,” he said.

    “One thing people have thought about, since we know that a-fib leads to an increased risk of stroke, is could there be subclinical strokes or micro-strokes going to the brain that may not manifest themselves as a clear clinical stroke but over time, lead to dementia?” he suggested. “That’s one concern we’ve always had.”

    It’s not clear whether a-fib causes dementia or is a marker for other disease processes that increase the risk for dementia, Epstein said.

    The best way to avoid developing a-fib is to maintain a normal weight and blood pressure, avoid sleep apnea, get plenty of exercise and eat a healthy diet, he advised.

    “Managing those things aggressively may reduce the incidence of atrial fibrillation,” Epstein said. “But interestingly, those are all the same things that if you manage aggressively also reduce your risk of dementia.”

    He said another open question is whether treating a-fib — by keeping the heart in a normal (sinus) rhythm — will lower dementia risk.

    Medications can help maintain a normal heart rhythm, but they don’t work for everybody and can have serious side effects, Epstein said.

    The other option is ablation, a treatment in which heat is used to deaden the areas in the heart that are causing a-fib. This can be effective in the long term but it doesn’t work for everyone, Epstein noted.

    The findings were published online March 8 in the Journal of the American Heart Association.

    More information

    For more on atrial fibrillation, head to the American Heart Association.

     

    SOURCES: Nisha Bansal, MD, professor, medicine, University of Washington, Seattle; Laurence Epstein, MD, system director, electrophysiology, Northwell Health, Manhasset, N.Y.; Journal of the American Heart Association, March 8, 2023, online

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  • Marijuana, Meth, Cocaine Use Can Help Trigger Dangerous A-Fib

    Marijuana, Meth, Cocaine Use Can Help Trigger Dangerous A-Fib

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    By Steven Reinberg 

    HealthDay Reporter

    THURSDAY, Oct. 20, 2022 (HealthDay News) — Using marijuana increases the risk of developing the heart rhythm disorder atrial fibrillation (a-fib), a new study suggests.

    It’s been known that drugs such as methamphetamine, cocaine and opiates can directly affect the heart and cause abnormal rhythms like a-fib, but weed can increase the risk by 35%, researchers found.

    “There is a common perception that cannabis may be healthy because it’s ‘natural,’” said lead researcher Dr. Gregory Marcus, a professor of medicine at the University of California, San Francisco. “But as laws become more lenient in allowing use of these substances, it’s important to recognize adverse consequences that may substantially impact the lives of users.”

    This study doesn’t prove drug use causes a-fib, only that users seem to be at greater risk.

    “These data are sufficiently compelling to suggest that cannabis users suffering from atrial fibrillation should at least experiment with cessation to see if it indeed has a meaningful effect on their particular arrhythmia,” Marcus said. “Once one has had an episode of atrial fibrillation, I find that patients are often especially eager to identify anything they can do to avoid subsequent episodes.”

    A-fib reduces quality of life and increases the risk of stroke, heart failure, kidney disease, heart attack and dementia, he said.

    “We used to think that a diagnosis of atrial fibrillation was just bad luck, but we now recognize this common and sometimes devastating disease can actually be prevented, largely with lifestyle interventions such as reducing alcohol consumption or enhancing physical fitness,” Marcus said. “Although various treatments are available, avoiding the disease in the first place is always better.”

    Methamphetamine, cocaine, opioids and cannabis use were each associated with a heightened risk for a-fib in the study, even after adjusting for multiple established risk factors for the disease.

    Methamphetamine increased a-fib risk by 86%, researchers found. For cocaine, the risk rose 61%, and for opiates, 74%.

    For the study, Marcus and his colleagues collected data on more than 23 million people treated in California emergency rooms from 2005 through 2015.

    Of 1 million patients who had no preexisting a-fib but developed it later, nearly 133,000 had used marijuana. Nearly 99,000 had used methamphetamines; nearly 49,000 had used cocaine, and 10,000 had used opiates.

    How marijuana increases a-fib risk is unknown, Marcus said.

    “There are several candidates, and they may act in concert,” he said.

    Inhalation of combustible products is known to trigger an inflammatory response, and acute inflammation heightens a-fib risk, Marcus said. In addition, blood from the lungs flows directly to where a-fib begins — the pulmonary veins and left atrium of the heart. As such, lung irritants such as pot smoke could aggravate areas of the heart that are particularly vulnerable to arrhythmia.

    All of the drugs studied can have dramatic effects on the link between the nervous system and the heart, Marcus noted. “Rapid fluctuations occur with the use of these substances and can also trigger atrial fibrillation,” he said.

    A-fib is an abnormal pumping rhythm caused by electrical disturbances in the heart’s upper chambers, the atria. In severe cases, clots can form in the atria and then break off into the bloodstream, causing strokes. Strokes related to a-fib claim more than 150,000 Americans a year.

    In addition, cocaine and meth can lead to sudden cardiac death from disruptions in the electrical signaling and pumping in the ventricles, the heart’s lower chambers. Researchers said there is no way, however, that pot causes these life-threatening arrhythmias.

    Dr. Laurence Epstein, system director of electrophysiology at Sandra Atlas Bass Heart Hospital in Manhasset, N.Y., said many factors can trigger a-fib. Therefore, it’s not easy to predict which will trigger an episode.

    “I don’t think it’s like, oh my God, nobody should ever smoke weed because they’re going to develop a-fib,” said Epstein, who wasn’t part of the study. “Everybody’s different. I have patients I treat for atrial fibrillation, and we talk about triggers, and everybody’s different.”

    For some patients, coffee or chocolate may trigger an episode, and for some, the trigger may be marijuana, Epstein said. Patients who are sensitive to it should avoid it, he advised.

    “My recommendation to patients is know thyself,” Epstein said. “Moderation is the key. If you find every time you get high, you start having palpitations, maybe that’s not for you. If you’re not having issues with it, then I’m not sure that puts you at increased risk.”

    With the other drugs discussed in the study, the risk is known, Epstein said.

    “It’s not only the risk of a-fib, but the risk of other bad things, which can give you an acute heart attack or cardiac arrest,” he concluded.

    The findings were published Oct. 18 in the European Heart Journal.

    More information

    Learn more about atrial fibrillation from the American Heart Association.

     

    SOURCES: Gregory Marcus, MD, professor, medicine, University of California, San Francisco; Laurence Epstein, MD, system director, electrophysiology, Sandra Atlas Bass Heart Hospital, Manhasset, N.Y.; European Heart Journal, Oct. 18, 2022

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