Atrial fibrillation (AF), the most common arrhythmia in older people, appears increasingly frequently in younger people, in whom it can also cause serious consequences. This is confirmed by the experience of cardiologists and corroborated by a recent study carried out in the USA.
This heart disease, which increases the risk of suffering a cardiovascular accident, has become the most treated type of arrhythmia in Spanish hospitals and its growth is exceeding all expectations. “There is talk that a true epidemic of AF could occur within 10 or 20 years,” says Ignasi Anguera, director of the arrhythmia unit at the Bellvitge hospital.
AF is an arrhythmia, that is, an alteration in the heart rhythm. This condition, which increases the risk of heart failure and stroke, has historically been associated with age and it has been considered that in young patients it was not a factor in the development of other pathologies. A study from the University of Pittsburgh Medical Center with data on more than 67,000 people treated, a quarter under the age of 65, concludes that these patients have a significantly higher risk of hospitalization for heart failure, stroke and myocardial infarction than women. people without atrial fibrillation.
The finding is alarming, in the sense that there are more and more cases of AF in all age groups, especially among young people, confirms Ivo Roca, head of the arrhythmia section at the Hospital Clínic of Barcelona. In his opinion, several factors explain this extension: “First of all, everyone is more alert in detecting it, because what was thought to be a benign arrhythmia is now seen to be serious. As we have new detection instruments, we are screening younger patients every day. Surely there are no more, but we detected it before.”
On the other hand, AF is part of the group of diseases caused to a certain extent by cardiovascular risk factors. “The diet has caused obesity to increase in our environment, as happened years ago in the US among young people,” reasons the cardiologist.
According to experts, another phenomenon that explains the increase in the prevalence of AF among young people is smart watches, capable of performing electrocardiograms with high precision and sounding the alarm. Thus, many cases of asymptomatic AF or those with mild symptoms have been detected: palpitations or accelerated heartbeat.
According to Dr. Anguera, the fact that AF affects a subgroup of young patients without other heart diseases (isolated atrial fibrillation) is a characteristic detail. The increase in cases responds to the ease of detection and the existence of very prominent triggering factors: high blood pressure, excessive alcohol consumption, sleep apnea, obesity or a sedentary lifestyle. Until a few years ago other arrhythmias were more frequent, now AF is number one and growing without brakes. “The increase in incidence is always more important than expected, each time the forecasts are exceeded in the number of patients we are caring for. There is talk that it could become a true epidemic within 10 or 20 years,” says the cardiologist.
It has been proven that sport is cardioprotective. Although, paradoxically, if practiced in excess it can become a trigger for AF, and this excess is usually carried out by young people. “There is a subgroup of individuals who perform high-intensity exercise for many hours in training and competition,” says Anguera. This practice causes an increase in heart rate that causes abnormalities in the heart muscle (fibrosis) and over time significantly increases the chances of developing an arrhythmia.
Given the increase in cases and the realization that they can also trigger serious consequences in young people, prevention, Anguera invokes: “It is important because young people tend to think that they are free of cardiovascular risks and there is a certain laziness. They have to have good control of hypertension, do moderate and regular physical exercise, control weight and treat sleep apnea. It is difficult for young people to take charge, but they have to do it.”
