The Rising Tide of Atrial Fibrillation: Is Primary Care Ready?

Interesting article. At the last conference I went to this summer, AFIB is expected to become "epidemic" by 2030. Sobering thought.


[www.medscape.com]

increased energy drinks,, booze, faster lifestyle and dietary changes perhaps.

Booze has been around forever and the two youngest generations drink less than we did. I don't buy into caffeine as a cause. I would point at obesity, diabetes, and a population that continues to age. The Baby Boom peaked in 1957, so plenty of time to see that curve continue to rise.

I would say it's the penchant for prepared foods, meaning manufactured, manipulated, artificial, highly flavored, processed. Nobody wants to cook any more, and they certainly tell themselves that they don't have the interest or time to go to a grocery store to buy produce and whole meats, and then to take them home and prepare them. Instead, it's deli sandwiches (fat, processed meats, cheese), Doritos, Twinkies, soda pop, beer, jerky/hot sticks, sweetened and caffeinated sports and booster drinks....nothing that has to be cut up, boiled, or steamed. After 30 years of that, starting at age 14, you can expect the body to begin to show wear 'n tear. Let's not forget recreational drugs, right from marijuana all the way up to crack and the lates synthetics. Anyone who thinks they're improved and safer has rocks in their head. Throw in hours of gaming until 0200 in the morning, and then rising to get to work by 0800....little sleep, no exercise, stale room air.

I am a baby boomer. After my diagnosis for atrial fibrillation learned that there were potential "triggers" that caused the arrhyithmia. Often read on this site about the trigger that caused an issue with others. I spent a considerable amount of time trying to determine my cause by eliminating the potential trigger.....stopped caffiene, stopped alcohol, stopped spicy food, stopped many others, was not overweight, exercised.. Nothing seemed to prevent an episode, and I gave up the effort.

Finally, went to see Natale for an ablation. When I told him of my efforts, he dismissed the trigger idea and told me I was genetically predisposed for arrhythmia.


Steve

No one is talking about the elephant in the room.
Increased vaccinations. Especially the new MRNA covid shots.

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calvin
No one is talking about the elephant in the room.
Increased vaccinations. Especially the new MRNA covid shots.

'Elephant' doesn't strike me as the appropriate characterization:

[pmc.ncbi.nlm.nih.gov]

Quote

A total of 2611 events of AF were reported after COVID-19 vaccination, of which, 315 were new-onset AF. As of January 7, 2022, a total of 523.12 million COVID-19 vaccine doses were administered, making the incidence of atrial fibrillation around 5 per million COVID-19 vaccine doses administered.

YMMV, of course.

I was curious if in addition to Carey and Gloaming’s replies of trigger speculations, if stress and environmental triggers could also across the board be included as a blanket cause.

I spent some time in the South Pacific in my youth (U of Hawaii and visits to Tahiti and other Islands and also a South Pacific Medical Anthropology minor).

In my limited observation, they were the most chilled out people I ever met or read about (except for the headhunters in New Guinea in the 50s) ..even the Leper colony’s truck we hitched a ride with in one of the Islands they were chilling folks.

So I googled if the South Pacific has a low occurrence or high for AF.

According to this study, it’s high.

Burden of atrial fibrillation in Māori and Pacific people in New Zealand: a cohort study
[pubmed.ncbi.nlm.nih.gov]).

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calvin
No one is talking about the elephant in the room.
Increased vaccinations. Especially the new MRNA covid shots.

Following a worldwide pandemic with a virus known to cause heart damage, you're going to blame vaccines? Have you thought this one through?

Also, the increase in afib isn't a sudden spike that coincides with the development of the vaccines. It was happening before then.

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NBeener

No one is talking about the elephant in the room.
Increased vaccinations. Especially the new MRNA covid shots.

'Elephant' doesn't strike me as the appropriate characterization:

[pmc.ncbi.nlm.nih.gov]


A total of 2611 events of AF were reported after COVID-19 vaccination, of which, 315 were new-onset AF. As of January 7, 2022, a total of 523.12 million COVID-19 vaccine doses were administered, making the incidence of atrial fibrillation around 5 per million COVID-19 vaccine doses administered.


YMMV, of course.

I believe that the incidence of undesired effects attributed to MRNA vaccines, across at least four major manufacturers, is a false attribution. The problem lies not in the vaccine, itself, since many other MRNA vaccines are currently in use, but in the way they were administered by harried personnel, some of whom had to learn hours earlier how to administer injections. The proper procedure is to insert the needle, withdraw the plunger, and to see if any venous/arteriol blood enters the syringe. This is called 'aspirating'. If there is blood, it means the needle must be relocated so that it is in adipose tissue or given intramuscularly. You don't inject vaccines directly into veins because it goes directly to the heart. Accordingly to Dr. John Campbell, PhD, who taught nursing science at a British university (and who has been vlogging on Youtube since before COVID), a great many cases of pericarditis can be directly attributed to the failure by nurses and other busy people to properly aspirate prior to depressing the plunger.

Quote

Accordingly to Dr. John Campbell, PhD, who taught nursing science at a British university (and who has been vlogging on Youtube since before COVID), a great many cases of pericarditis can be directly attributed to the failure by nurses and other busy people to properly aspirate prior to depressing the plunger.

Does Campbell have published data to back that up? It's long been taught to nurses and others who do injections to aspirate before injecting, but there's debate over how important that really is. The odds of an intramuscular injection needle ending up in a vein is really remote because veins run longitudinally up and down the limbs, but needles go in at a 90-degree angle to the veins and they don't go deep enough to encounter large veins. It's a complete lotto win to actually place an intramuscular injection into a vein.

My n=1 with C19 vaxes (both mRNA & J&J) is an association with a dramatic increase in afib episodes. I finally successfully used low dose flecainide (50 mg/day, then 25 mg/day) to avoid the episodes. Initially unsuccessfully tried a number of times to discontinue the flec. I finally hypothesized if I quit getting boosters and could get far enough away in time from a vax that I could have successful discontinuation. Eight months proved to be sufficient time for me. As I've visited a relative in a nursing home multiple (3-4+) times a week for over 3 years (& "outbreak status" for C19 is very common) without ever getting C19, I decided I would decline future C19 vaxes. I also pay extensive attention to not having any comorbidities.

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Carey
Accordingly to Dr. John Campbell, PhD, who taught nursing science at a British university (and who has been vlogging on Youtube since before COVID), a great many cases of pericarditis can be directly attributed to the failure by nurses and other busy people to properly aspirate prior to depressing the plunger.

Does Campbell have published data to back that up? It's long been taught to nurses and others who do injections to aspirate before injecting, but there's debate over how important that really is. The odds of an intramuscular injection needle ending up in a vein is really remote because veins run longitudinally up and down the limbs, but needles go in at a 90-degree angle to the veins and they don't go deep enough to encounter large veins. It's a complete lotto win to actually place an intramuscular injection into a vein.

He has been citing UK ministry of health's own published data, including an admission in late '23 that the 'unnaccounted for deaths' and higher incidents of heart problems in younger men, especially, is apparently, not conclusively, associated with the MRNA vaccines for COVID...not MRNA in general.

Electronic pollution galore. Its everywhere.

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gloaming
He has been citing UK ministry of health's own published data, including an admission in late '23 that the 'unnaccounted for deaths' and higher incidents of heart problems in younger men, especially, is apparently, not conclusively, associated with the MRNA vaccines for COVID...not MRNA in general.

COVID itself is known for the same thing, so teasing the actual causes apart is difficult. It could be that the COVID vaccine is initiating the same inflammatory response that the virus does in young men, and especially athletic young men. I've seen some discussion about how the athleticism itself may be a factor all on its own because even unvaccinated young athletic men have seen increased rates of cardiomyopathy after COVID infections.

One thing's for sure: Medicine ain't simple.

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Todd
Electronic pollution galore. Its everywhere.

While I don't know about electronic pollution, air pollution has been found to increase the likelihood of arrhythmias:

[www.ahajournals.org]

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the study
In this large cohort study, long‐term exposure to outdoor P[articulate] M[atter] air pollution was associated with increased risk of arrhythmia. Our findings indicate that PM air pollution may be a contributor to cardiac arrhythmia in the general population.

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JAYHAWK
I am a baby boomer. After my diagnosis for atrial fibrillation learned that there were potential "triggers" that caused the arrhyithmia. Often read on this site about the trigger that caused an issue with others. I spent a considerable amount of time trying to determine my cause by eliminating the potential trigger.....stopped caffiene, stopped alcohol, stopped spicy food, stopped many others, was not overweight, exercised.. Nothing seemed to prevent an episode, and I gave up the effort.

Finally, went to see Natale for an ablation. When I told him of my efforts, he dismissed the trigger idea and told me I was genetically predisposed for arrhythmia.


Steve

I could tell about the same for me (but I did not meet Natale - I'm from Belgium).
Both my cardiologist and EP said I'm predisposed (both parents afibbers).
Can't find triggers. Just circumstances increasing the risks to have an episode.

Looks like AF is the gift of Inheritance.. Search it some more.
Chromosome 4q25 variants are genetic modifiers of rare ion channel mutations associated with familial atrial fibrillation.
This study tested the hypothesis that two common polymorphisms in the chromosome 4q25 region that have been associated with atrial fibrillation (AF) contribute to the variable penetrance of familial AF.
[pmc.ncbi.nlm.nih.gov]

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Todd
Looks like AF is the gift of Inheritance.. Search it some more.

Yes, however the odds ratios quoted aren't guarantees, just a greater prevalence.

Question is, if it is Genetic - mine likely is - what can you do about it?

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sldabrowski
Question is, if it is Genetic - mine likely is - what can you do about it?

My EPs NP told me I have a genetic disposition of getting AF flair ups after ablations. She said she could eat my triggers without any problems but she knew I couldn’t. Maybe I that’s why my ablations failed after 6, 3, 1 months. My EP tried his best. He told me I lit up like a Christmas tree when he went in shocked and surprised and it just a mass quantity during a routine 3rd touch up.

I heard here the success rate by a top tier EP being around 90% (I think it’s more in the 70%). However, I wonder if there was a study done on the success rate of someone having a genetic disposition to afib and their severity. My mom lived to 95 and never had an ablation nor ECV and she had frequent afib. She just naturally converted. She was lucky in that sense.

6 years since my last ablation, always AFib from time to time, AVG 60min length. Always self revert without any drug. I just wait and get back to nsr without worrying about it.
Next day after my last ablation, as I was in NSR, I said to my EP it maybe was a good sign. His reply was : "with you, I make no prognosis".