Atrial fibrillation would affect more than 750,000 people in France. As part of the 2021 Week of Action concerning this disease, Why Doctor offers you a series of articles to better understand atrial fibrillation, its symptoms and the treatments to control it. Pr François Puiseux, geriatrician at the University Hospital of Lille, explains how atrial fibrillation is mainly a disease of the elderly.
- Two-thirds of patients with atrial fibrillation in France are elderly
- Treatment with anticoagulants reduces the risk of stroke
- These treatments require monitoring and good compliance due to the risk of bleeding.
“Atrial fibrillation is a pathology of the elderly which can have serious consequences”, warns Pr François Puiseux, geriatrician at the Lille University Hospital. It is estimated that after the age of 80, one person in two suffers from this disease and that two thirds of the approximately 750,000 patients in France suffering from atrial fibrillation, which consists of a disturbance of the heart rhythm, are elderly people. AF is characterized by dysfunction of the contraction of the atrium, preventing proper ejection of blood to the ventricle, which leads to a risk of clot formation. And it is indeed, this risk of clot which generates the most important danger in the event of atrial fibrillation: stroke. The clots that form inside the heart can be sent to the cerebral circulation, with a major risk of hemiplegia which strongly impacts the quality of life.
The importance of anticoagulant treatments
“It is for this reason, insists Professor Puiseux, that it is imperative to identify atrial fibrillation as soon as possible, especially since we have effective treatments”. These treatments are mainly based on anticoagulants. “In the elderly, anticoagulants which are intended to correct cardiac arrhythmias do not allow a normal sinus rhythm to be restored because often atrial fibrillation is installed on an aged heart, but they prevent the risk of stroke”, insists the geriatrician.
But these treatments require strict compliance and above all monitoring of the patient. If they prevent the risk of thromboembolism -the reduction in the risk of stroke is estimated at 70%-, they do indeed increase the risk of hemorrhage. But, as Professor François Puiseux points out, “in the elderly, the risk-benefit ratio of prescribing anticoagulants in the event of atrial fibrillation is maximal.
Prevention of memory diseases
Because beyond their effect against the danger of stroke, these drugs also prevent the onset of memory diseases. “By disrupting the proper circulation of blood in the brain, atrial fibrillation contributes to the appearance of neuro-cognitive disorders”, specifies Professor François Puiseux, insisting on the observance by seniors of these treatments, the new formulas of which have also reduced the risk of bleeding.
Below, the interview with Pr François Puiseux:
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