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Atrial fibrillation is a gateway to a number of other dangerous medical complications so it is important to diagnose the disease as possible. Screening tests and lifestyle modifications are the best way to help patients cope with this new challenge.

Atrial fibrillation is a serious disease and becomes more likely as patient ages. The prevalence of this disease can be as high as nearly 20 percent of patients over the age of 80 [1]. With the disease expected to more than triple in cases in the next 40 years, it is imperative that patients at risk do whatever they can to make sure that they are screened accordingly to catch the disease early to find adequate treatment for atrial fibrillation [2]. Atrial fibrillation is a disease that predisposes a patient to a number of harmful side effects including: 

  • strokes,
  • peripheral emboli,
  • increased mortality.

Even with adequate management, there is a strong risk of atrial fibrillation recurrence with nearly 50 percent of patients experiencing relapses in symptoms after medications and surgical ablations [3]. 

The Best Way to Diagnose Your Atrial Fibrillation: Screening Tests 

An unfortunate dilemma in the medical community is how to effectively screen for atrial fibrillation. There are multiple recommendations that vary from country, state and even medical offices in some cases leaving both patients and physicians frustrated with this ambiguity.

Currently, most patients ultimately diagnosed with atrial fibrillation come in to their family doctors complaining of 

  • chest pain,
  • heart palpitations 
  • anxiety 

before they are eventually diagnosed with atrial fibrillation.

A study was done to determine if a traditional patient visit with complaints was a more reliable way to diagnose compared to potential screening tests. At the conclusion of the study, the researchers determined that both screening tests and opportunistic exams were better ways to screen patients instead of after a patient already has symptoms. It was also evident that systematic screening of an elderly population was very expensive and would not be an effective method to screen on a national level. [4]

There are two general screening tests that can be done to determine if a patient is suffering from a hidden atrial fibrillation:

  • 12-lead electrocardiogram (EKG)
  • opportunistic blood pressure tests [5].

Both tests have their advantages, inexpensive and are easily incorporated into a general well-visit at your family doctor. 

A recent study conducted in the UK determined the ideal recommendation to determine atrial fibrillation in over 2,000 patients. This study confirmed that the most accurate diagnosis of atrial fibrillation occurred after patients were tested 3 subsequent times for their blood pressure [6].

A subsequent study took this test one step further and tried to determine an effective and cost-efficient method to determine how to screen a large population of patients. Participants aged 65 years and older had their blood pressure checked when they came to a clinic for their annual flu shots. Out of the nearly 600 participants, 95 had an irregular rhythm but only 2 were successively diagnosed with new-onset atrial fibrillation after only a third returned for subsequent reevaluation. At the conclusion of the study, it was determined that this method may be feasible because patients are already coming into the clinics for a flu vaccination but researchers believe that once patients are diagnosed with an irregular blood pressure, they should instantaneously have an EKG performed to determine if they indeed have atrial fibrillation. [7]

How to Manage Life with Atrial Fibrillation 

Once you are diagnosed with atrial fibrillation, the real challenge starts as you will have to deal with a gauntlet of medications, surgical procedures and lifestyle modifications including exercise tips in order to have a complete atrial fibrillation treatment.

Patients suffering from atrial fibrillation also have an increased risk for:

  • strokes,
  • internal bleeding, 
  • heart failure [8].

Patients are grouped into specific risk categories which can be managed with oral agents to prevent your blood from clumping (called anticoagulants) [9]. 

One of the most common agents you are likely to encounter with your atrial fibrillation management is an anti-coagulant referred to as Warfarin. This agent is very effective at preventing blood from clotting together but the one unfortunate caveat with this medication is patients will require a rigorous schedule of check-up visits to make sure that the levels of Warfarin do not get too high. The complications of Warfarin are extensive and include: 

  • increased likelihood of bleeding,
  • depleting important vitamins in the blood [10].

Because of these dangerous side effects, physicians are often wary of prescribing too much of this medication at once and systematically begin with too low of a dose to make sure that patients are only given what they ultimately will need. In one study targeting the dosing strategy for patients, the dosage for patients was changed in almost 75 percent of cases even after one year of trying to find the ideal dose [11].  

The best advice for patients who are on long-term treatment with Warfarin is to make sure that they adequately alter their atrial fibrillation diet to supplement the vitamins used by Warfarin.

Patients needing this medication are encouraged to consume green, leafy vegetables like spinach and collard greens. This provides extra vitamin K and helps patients to better manage their bleeding episodes.

Patients are also encouraged to visit their physicians on monthly basis to have blood tests in order to determine if their Warfarin levels are still adequate. These visits will also allow a physician to run follow-up EKG and blood pressure evaluates to make sure that there are no recurrent episodes of atrial fibrillation. [12]

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