Medical Practice

How Concerned Should Patients Be About An Irregular Heartbeat?

By KOUSIK KRISHNAN, MD

As many industries and individuals are struggling publicly with burnout, a new study from the European Journal of Preventative Cardiology links the “burnout syndrome” with atrial fibrillation (afib). The findings are both interesting and valuable. In general, the public benefits from anything that can raise awareness of heart disease, because early intervention directly impacts improved patient outcomes.

However, headlines that describe afib as a “deadly irregular heartbeat” go too far in the name of public awareness. The truth is, afib is not a sudden killer like a heart attack, cardiac arrest, or stroke. While afib is undeniably serious, it can often be identified in advance and managed with evaluation and treatment. 

Afib is a very common arrhythmia that has numerous risk factors, including hypertension, diabetes, obesity, and sleep apnea, to name just a few. When the heart goes into atrial fibrillation, the upper chambers go into a fast, chaotic and irregular rhythm that often makes the pulse race and feel irregular. Other symptoms can include palpitations, shortness of breath, and dizziness. Some people may not have any symptoms at all. Stroke is the most devastating consequence of atrial fibrillation, but is rarely the first manifestation of the disease.

It is also important to note that afib may not always be present. For this reason, often the arrhythmia is gone by the time someone seeks medical attention, making the arrhythmia harder to diagnose. Fortunately, consumer devices, such as the new Apple Watch, have algorithms to help detect atrial fibrillation. These technologies hold immense promise. They are already helping many people manage their health, and even potentially diagnose some people who never knew they had afib.

Furthermore, health care professionals now have excellent medical treatments to address the two major aspects of care: improving symptoms and reducing the risk of stroke. Medications and advances in nonsurgical procedures, such as catheter ablation, can dramatically improve patients’ quality of life and allow people to lead a normal life. Blood thinners can dramatically reduce a patient’s risk of stroke. 

No doubt, atrial fibrillation is serious, and dramatic news about health conditions can open the public’s eyes. For example, when NBC journalist Tim Russert died of a heart attack in 2008, despite a normal stress test just prior to his death, it raised awareness about the risk factors for heart attacks and the limitations of diagnostic testing. 

Likewise, the study linking burnout to afib will resonate with many people, especially those who suffer from chronic workplace stress. But those who are already burned out should not be burdened with the additional stress of being told that if they develop afib, they have somehow developed an imminently deadly condition.

Improving awareness of a common arrhythmia, such as afib, and linking it to burnout syndrome is an important scientific discovery. Let’s use the opportunity to educate and offer hope for the many treatments we have, and leave the fearmongering at the door.

Dr. Krishnan is a cardiologist and assistant professor at Rush University Medical Center in Chicago, as well as a Public Voices Fellow with the OpEd Project. 

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