Research: more frequent heart rhythm recovery can lead to fewer strokes and infarcts

Some people with cardiac dysrhythmia ‘atrial fibrillation‘ are better off with a different treatment than they are receiving now. That’s what researchers are writing today in The New England Journal of Medicine. This is expected to prevent strokes, heart failure and heart attacks in several hundred patients in the Netherlands every year. It also reduces the risk of death.

“In healthy people, the heart beats regularly and about 80 times a minute“, says Harry Crijns, head of the cardiology department at the Maastricht UMC and one of the project leaders of the study. “A quarter of all people over 40 experience at some point atrial fibrillation. The heartbeat then becomes irregular and the number of beats per minute increases. People can suffer from palpitations, dizziness and a feeling of pressure on the chest. In addition, especially in the first year after diagnosis, they are at greater risk of serious complications such as stroke, heart failure or a heart attack.”

In patients who do experience complaints, doctors try to restore the heart rhythm with medication or by turning off the piece of heart that disturbs the rhythm, for example by freezing.

Extra risk

In patients in whom no attempt was made to restore the rhythm, 5 percent developed a serious complication such as stroke, heart failure, a heart attack within a year. Some even died. In the group where doctors did try to restore the rhythm, 3.9 percent developed complications

Cardiologist Crijns estimates that there are some 15,000 to 20,000 patients in the Netherlands each year who would be wise to restore the heart rhythm and he expects that this could save some 200 people from a serious complication

Gamechanger

“This is an important investigation into a common arrhythmia”, reacts Professor Folkert Asselbergs, cardiologist at the UMC Utrecht. “In practice, we always ask ourselves whether you should just slow down the heartbeat or whether you should also strive to restore a regular heart rhythm. Previous studies have shown different results, but this study shows that people are better off with a normal heart rhythm.”

Asselbergs expects that the study will soon find its way to the clinic if follow-up research shows that the treatment is cost-effective. “I think that we will then try more often to get a normal heart rhythm back in people who have recently been diagnosed with atrial fibrillation and who are over 65 years of age and are otherwise at extra risk. We’re probably less likely to give up if we don’t succeed immediately.”