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. With Professor Philippe Mabo, cardiologist at the Rennes University Hospital, an update on screening, when and how.
- Symptoms of atrial fibrillation are palpitations, shortness of breath, fatigue
- Screening is done by taking a pulse or an electrocardiographic examination.
- This screening, even in the absence of symptoms or risk factors, is recommended from the age of 65
Affairs of the heart must be approached with reason! If you have palpitations, a feeling of shortness of breath on exertion or simply a little more fatigue, it may be a sign of atrial fibrillation. A disease which concerns more than 750,000 people in France and which mainly affects those over 65, but above all a so-called “silent” disease which can exist without real symptoms appearing. Hence the importance, from the age of 65, of monitoring your heart rate because it is its dysregulation which is the main consequence of atrial fibrillation. But as Professor Philippe Mabo, cardiologist at the Rennes University Hospital, points out, “you shouldn’t make it an obsession, spend your life with your hand on your pulse, but do it in a reasoned and reasonable way!”.
Spot the symptoms… when they exist
And yet, detecting in time atrial fibrillation, a dysfunction of the mechanism of contraction of the auricle which can let the blood stagnate in the heart and therefore generate a strong risk of cerebrovascular accident because of the formation of clots, it is the best way to avoid a serious clinical event. But when and how to do this screening? “First, explains Professor Philippe Mabo, when you have symptoms, palpitations, feeling of racing heart, shortness of breath on exertion, inexplicable fatigue. And of course for patients who have already had a stroke or who suffer from heart failure, this screening must be systematic”.
The problem is that atrial fibrillation can exist without any signs and without any history of heart problems. “As it is a disease that can be silent, it is important to do screening from the age of 65 – two thirds of people suffering from atrial fibrillation are over 65 – but we can do it more early especially if you have a risk profile, that is to say if you suffer for example from hypertension or diabetes”, specifies the cardiologist.
A diagnosis that can be based on connected objects
Screening for atrial fibrillation, how does it work? There are several methods and tools to monitor your heart rate and any abnormalities. First, and this is the simplest way, there is the pulse. “This is done at the level of the wrist or the carotid artery: if the pulse is rapid and irregular, if it beats wildly, it is then advisable to consult your doctor or a cardiologist”, warns Professor Philippe Mabo.
But the only examination that allows a sure diagnosis of atrial fibrillation is the electrocardiogram, “but on condition that it is carried out when the symptoms are present”, insists the cardiologist. Hence the interest in also using long-term electrocardiography techniques, either with the placement of electrodes on the thorax connected to a recording box for 48 to 72 hours, or the use of a holster whose implantation makes it possible to monitor the heart rate over several weeks with the additional capacity of being able to transmit the data recorded to the doctor. Despite the recognized effectiveness of these devices, “the revolution in the detection of atrial fibrillation, assures Professor Philippe Mabo, it is connected objects that measure and record the heart rate in real life, with even alerts to report possible abnormalities, and on which doctors can now rely to make a diagnosis”.
Below, the interview of Pr Philippe Mabo, cardiologist at the CGHU of Rennes:
Our Q&A program on atrial fibrillation:
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