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Contact:ajekowsk@acc.org;
202-375-6645
February 18, 2008
Focus on Atrial Fibrillation Recognizes
Growing Importance of Common Arrhythmia
Special issue of JACC features intriguing link between
statins and AF prevention, tools to ensure the highest-quality
AF care, and more
When we’re young, a racing heart often means love is
in the air. If you’re a “baby boomer,” it
might mean you’ve just joined the 2.2 million Americans
who have atrial fibrillation (AF), an irregularity in the
heart’s rhythm that grows more common as we age and
markedly increases the risk for stroke.
“We’re seeing more and more patients with atrial
fibrillation,” said N.A. Mark Estes III, M.D., F.A.C.C.,
a professor of medicine at Tufts University School of Medicine
and director of the New England Cardiac Arrhythmia Center
at Tufts-New England Medical Center, Boston. “The good
news is that we have practical and useful tools to use in
assessing patient risk and good evidence on how to treat this
condition.”
Atrial fibrillation occurs when the upper chambers of the
heart—the atria—quiver in an uncoordinated way
rather than contracting with a steady tempo. Not only can
this result in a rapid, irregular heart beat, but blood can
pool in the atria and form clots that travel to the brain,
causing a stroke. Some 3 percent to 4 percent of people over
age 60 have atrial fibrillation, a risk that climbs to more
than 5 percent after age 70.
The February 26, 2008, edition of the Journal of the American
College of Cardiology (JACC) places a spotlight on atrial
fibrillation, with a special focus issue featuring review
articles, editorials, and original research on the diagnosis
and management of this common arrhythmia. One research study,
for example, raises the intriguing possibility that statins—medications
that are widely prescribed for lowering cholesterol levels
and reducing the risk of heart attack and stroke—may
also reduce the risk of atrial fibrillation.
For the study, researchers from France analyzed data from
six randomized controlled trials involving nearly 3,600 patients,
all of whom either had experienced atrial fibrillation in
the past or had a high risk of developing new atrial fibrillation
following a heart attack or coronary bypass surgery. The researchers
found that patients who were taking statins were 61 percent
less likely to develop atrial fibrillation than were patients
not taking these medications.
Laurent Fauchier, M.D., Ph.D., who led the study, said it
is too early to consider prescribing statins to all patients
with a history of atrial fibrillation, but the results of
the analysis suggest statins may offer an intriguing bonus.
“A positive effect of statins on atrial fibrillation
may contribute to a reduction in the number of strokes or
episodes of worsening heart failure,” said Dr. Fauchier,
a professor of cardiology at Centre Hospitalier Universitaire
Trousseau, Tours, France. “What patients should know
is this: If your doctor prescribes a statin for any reason,
it will decrease the risk of cardiac events related to atherosclerosis,
and by the way, it may also decrease the risk of atrial fibrillation.”
Also included in the special focus issue of JACC is a set
of performance measures jointly developed by the American
College of Cardiology and the American Heart Association,
in collaboration with the Heart Rhythm Society. The performance
measures can be used by physicians and health systems to monitor
the quality of care delivered to patients with atrial fibrillation.
They focus on three key steps for the prevention of stroke:
1. Use of a simple point system to identify patients at high
risk for stroke; 2. Prescription of blood thinning medications,
particularly warfarin (Coumadin), to reduce the risk of stroke;
and 3. Monitoring of the effects of warfarin at least monthly.
“There is clear evidence that warfarin reduces the
risk of stroke,” said Dr. Estes, who chaired the performance
measures writing committee. “We’ve tried to develop
a practical and useful tool that physicians can use right
from the beginning, when a patient first comes to the office
with atrial fibrillation.”
Dr. Fauchier reports no commercial relationships related
to his study.
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The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 34,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
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The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of the
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