2024-04-11 13:32:05
Atrial fibrillation, a very common form of arrhythmia, might announce the presence of much more serious heart problems, concludes a systematic review led among others by a doctor from the Montreal Heart Institute.
The authors therefore recommend that patients with early-onset atrial fibrillation undergo clinical screening to eliminate the risks of ventricular cardiomyopathy and cardiac channelopathy, two syndromes caused by genetic variants that can put patients’ lives at risk. “In young patients whose atrial fibrillation has no obvious cause, it is important to take a family history to identify clues that might suggest the presence of a more serious pathology than simply atrial fibrillation, where the fibrillation ear becomes a first manifestation or symptom,” explained Doctor Rafik Tadros. Atrial fibrillation is the most common cardiac arrhythmia. It affects more than 1% of the population and is associated with increased risks of heart failure, stroke and dementia.
The condition is usually managed with medication, and sometimes with surgery. That being said, Dr. Tadros said, “there is a group of individuals, the extent of which is not yet well characterized, (…) where atrial fibrillation is the first manifestation of a more dangerous cardiac condition which would endanger life. “It’s still a minority of patients with atrial fibrillation,” he said. It is often younger patients who develop atrial fibrillation relatively early in life. It is important to identify these patients who not only have atrial fibrillation, but who also have potential hereditary conditions that endanger their lives, but also the lives of their families since these are hereditary genetic conditions. .”
And even if an individual presents a relatively mild form of atrial fibrillation, emphasized Dr. Tadros, given the genetic variability that can exist within the same family, it is not said that his brother, his aunt or his son will not present a potentially more dangerous form of the disease and whose life should be protected with appropriate treatment. There are still some aspects to be clarified, admits Dr. Tadros. For example, it is not yet known for certain whether young patients who present with atrial fibrillation, who have a family history of the disease, but who do not have genetic conditions, should be offered genetic testing.
“It’s a considerable population, it represents a lot of individuals,” he said. But for the moment, genetic testing is quite sophisticated, it’s complex, it requires training to properly interpret and act on the results.” Most people whose atrial fibrillation has an obvious cause ― such as age, hypertension or acquired heart disease ― would not benefit from genetic testing, Dr. Tadros added. But in case of doubt, for example in the face of the onset of the disease at a young age or in the presence of a family history of sudden deaths, these tests might become relevant and the patient is invited to speak to their doctor, a -he concluded.
The findings of this study were published by the Canadian Journal of Cardiology.
Photo credit: Courtesy: ICM, Jean-Benoit Legault.
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