Dr. T S Kler
Chairman, BLK-Max Heart & Vascullar Institute , Pusa Road , New Delhi .

On this World Heart Day , I am going to talk about

Atrial Fibrillation, which is labelled as 21st century cardiovascular disease epidemic. Atrial fibrillation is a condition in which Heart beats rapidly,irregularly and in a chaotic manner. The patient feels it as rapid and irregular heart beating which can be very uncomfortable. .

During AF the upper chambers of heart do’nt contract leading to stagnation of blood which predisposes to clot formation in the left atrium & these clots can go to brain & cause paralysis . AF also leads to Heart failure & increased mortality . Heart failure of any aetiology can also produce AF . So AF & heartfailure have duel negative relatioship . AF can cause heartfailure & heartfailure can bring in AF .

Earlier AF was considered a disease of the west but now with increasing longevity and better tools for its detection, it is seen increasingly common in Indian populations as well. The prevalence in general population increases steeply from 3% in 6th decade to above 13% in 8th and 9th decade. The lifetime risk of developing AF is 1 in 5 after age of 45years.

The risk factors for developing AF include hypertension, Diabetes, Coronary heart disease(CAD), Valve disease, obesity, smoking, obstructive sleep apnea(OSA),stress, thyroid disease, alcohol intake, dietary habits besides unknown impact of pollution and environmental factors.
AF increases the risk of heart attacks by 2-fold and stroke by 5-fold besides increasing the risk of heart failure , dementia and death.

With increasing awareness among patients and physicians as well as phenomenal increase in knowledge about AF, early detection and treatment strategies can prevent recurrence, take care of its consequences and even provide curative RF Ablation in certain subset of patients. The Cardiac Electrophysiologist are rightly positioned to tackle this arrhythmia and individualise, tailor-make the right treatment plan which can include RF ablation, LA appendage occlusion besides the right medications and anticoagulants to prevent strokes.

On this world heart day , we must pledge to prevent and treat this growing epidemic and together we can achieve it. ‘Regular beating heart is happy heart’