Dr Emelia J. Benjamin: Atrial Fibrillation Is Common and Increasing in Incidence

Emelia J. Benjamin, MD, ScM, is associate provost for faculty development at Boston University Medical Campus; cardiologist at Boston Medical Center, a large urban safety net hospital; professor of medicine, Department of Medicine, at Boston University Chobanian and Avedisian School of Medicine; and professor of epidemiology, Boston University School of Public Health.

At this year’s American Society for Preventive Cardiology’s Congress on CVD Prevention, she delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award—having received the honor for her extraordinary contributions to the field of preventive cardiology.

Here she describes what atrial fibrillation is, how the condition announces itself, and why this area of cardiovascular medicine is receiving so much attention.

Transcript

Can you explain what atrial fibrillation is and discuss how this cardiac condition presents itself?

Atrial fibrillation is an irregularly irregular heart rhythm. People may notice it if they have some kind of fitness device or some kind of heart rate tracking device; they may notice that their heart seems to be skipping or isn't going boom, boom, boom, but rather, ba boom, ba ba ba ba boom, boom, boom, boom like that. Sometimes people even feel it in their chest. On the other hand, oftentimes people are asymptomatic and the concern is that oftentimes their first presentation in the condition is a complication from atrial fibrillation.

Why is the need to focus on atrial fibrillation becoming so much more important at present?

Thank you so much for the question. I personally think that probably part of the problem is ageism, is that for many, many years, the conditions that were most studied happened in younger individuals. Now people are living longer with both cardiovascular disease and many other conditions, and so are going on to develop conditions such as atrial fibrillation. It turns out that the lifetime risk of atrial fibrillation for people of European ancestry is about 1 in 3, for people of African ancestry is about 1 in 5—so it's a very common condition that occurs more and more as people age.

In terms of why is it important now, it's increasing in incidence, meaning the number of new cases; prevalence, the number of existing cases; the lifetime risk; and the complications are significant, including stroke, coronary heart disease, myocardial infarction, heart failure. Turns out there's many other conditions that it’s associated with.