AFib: Why More People Under 65 Are Being Diagnosed

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The risk of AFib for people under 65 may be higher than previously thought. Anadorado/Getty Images
  • A new study suggests that atrial fibrillation (AFib) may be more common in people under 65 than previous research suggested.
  • Younger people with AFib also had an increased risk of dying or being hospitalized compared with people of the same age without AFib.
  • Experts say it’s not clear whether Afib is increasing in younger people or whether doctors are just diagnosing it more often. It can be both.

A new study suggests that atrial fibrillation (AFib or AF), a condition associated with irregular heart rhythms, is more common than previously thought in people under the age of 65.

Adults in this age group also had an increased risk of dying and being hospitalized. heart attackResearchers found that people with AFib are more likely to have heart failure or stroke than people in the same age group without AFib.

“The common wisdom among cardiologists is that, in people under age 65, AFib is extremely uncommon and not harmful. But there’s really no data to support it,” the study author said Aditya Bhosle, MDCardiac electrophysiologists at the Heart and Vascular Institute at the University of Pittsburgh Medical Center said in a release,

The study was published April 22 in the journal Circulation: Arrhythmias and Electrophysiology,

irregular heartbeatThe most common type of arrhythmiaaffected a Estimated 5.2 million Americans In 2010, this is expected to increase to 12.1 million by 2030.

This condition causes the heart to beat irregularly and sometimes faster than normal, which can cause symptoms such as dizziness, feeling tired, or lightheadedness. You may also feel that your heart is fluttering, beating too fast or hard, or skipping a beat.

Left untreated, AFib can cause heart disease or make your existing heart disease worse. This also increases the risk of complications such as heart failure And trauma.

“AFib is usually a disease of older people,” said Bradley Knight, MD, medical director of electrophysiology at Northwestern Medicine Bluhm Cardiovascular Institute in Chicago, who was not involved in the study. “As people age, they may develop abnormalities in their atrium [of their heart]Which can lead to atrial fibrillation.”

While the risk of AFib in older adults is well known, it was previously believed that the condition was not very common in younger adults.

For example, 2001 Study found that less than 1% of American adults under the age of 55 had AFib, while 9% of people age 80 or older had the disease. Similar results were seen in a recent European Study,

In the new study, UPMC researchers found that AFib was more common in their young patient population than seen in earlier studies.

To determine this, they reviewed the medical records of more than 67,000 adults who had at least two outpatient visits to a UPMC clinic related to a diagnosis of AFib between 2010 and 2019.

Although the average age of patients with AFib was 72 years, about one-quarter were under the age of 65, with the majority of younger patients being men.

The researchers also assessed the risks of hospitalization and death for young people with AFib. Other Research Research suggests that AFib increases the risk of dying early, but many of those studies focused on older adults.

After reviewing the 10-year survival of young patients, researchers found that men with AFib were 1.3 to 1.5 times more likely to die than men of the same age without AFib.

For young women with AFib, the risk of dying was 1.7 to 2.4 times worse than for young women without the condition.

Many people in this younger age group had risk factors cardiovascular diseaseWhich includes obesity, smoking, high blood pressureDiabetes, and obstructive sleep apnea.

Over time, these conditions can cause physical damage and electrical changes in the heart that result in AFib.

Jim Liu, MDA cardiologist at The Ohio State University Wexner Medical Center in Columbus, who was not involved in the study, said the study highlights that AFib in young patients is a “serious condition,” especially “because AFib is more common in young adults.” “Becomes more prevalent in the U.S. and is not isolated to just elderly patients.”

So is AFib really becoming more common in people under 65, or are doctors getting better at detecting the condition?

It could be a little bit of both.

“We are probably doing a better job at detecting AFib,” Liu told Healthline. For example, “Many people now have personal wearable devices, such as smart watches “And other monitors that can detect AFib.”

“However, risk factors for AFib – such as obesity, sleep apnea, diabetes and high blood pressure – are also increasing in younger patients.”

Other risk factors for AFib include consumption large amounts of alcohol and viral infections such as COVID-19,

Many of these can be modified to reduce the risk of developing AFib.

“It is important to address the risk factors for AFib,” Liu said. “It means achieving conditions like [high blood pressure], sleep apnea and diabetes are under control. If someone is overweight, it also means losing weight.”

Even though the new study suggests AFib may be more common in young people than previously known, Knight said clinical guidelines do not recommend routine screening of all patients for AFib.

,[Screening] May be important for patients with risk factors, especially older patients and patients with heart disease [high blood pressure],” he said, “but I don’t know that we need to investigate this in very young patients [who don’t have symptoms],

However, “[AFib] Screenings are being done more frequently because of these wearable devices that are available without a doctor’s prescription,” he said.

Knight believes this type of device could be useful in managing patients who have already been diagnosed with AFib. For example, if someone thinks they have possible symptoms of AFib, they can record their heart rhythm using their wearable device and send the recording to their doctor for review.

They may record their rhythm once a week after a heart procedure or change in their medications to see if their heart is staying in a normal rhythm.

“These are very valuable tools, but there is also the problem of false positives,” Knight said. “Many young, healthy people are told by their device that they have AFib,” but follow-up with a doctor may reveal that it was a false positive.

He advises anyone with cardiac symptoms heartbeat (fast heartbeat, palpitations, or racing heartbeat), chest pain, or sudden trouble breathing, talk to your doctor or other medical professional.

“One of the tests might be for them to wear a long-term heart monitor that would detect any atrial fibrillation they have,” Knight said.

Researchers examined the medical records of more than 67,000 people with AFib. Nearly one-quarter of these patients were under 65 years of age.

AFib was previously thought to affect those over the age of 65, with rates increasing with age. However, this study shows that the condition also affects younger people.

Many of the young patients with AFib in the study had risk factors such as obesity, high blood pressure, diabetes and obstructive sleep apnea.