Skip to content

Improved Identification of Patients at Risk for Atrial Fibrillation

In This Video

  • Steve Lubitz, MD, MPH, is a cardiac electrophysiologist at Mass General
  • Here he discusses his team’s work understanding the mechanisms of atrial fibrillation through human genetics, and how best to identify patients at risk for the arrhythmia

Steve Lubitz, MD, MPH, is a cardiac electrophysiologist. In this video, he talks about his team's efforts around understanding the mechanisms of atrial fibrillation through human genetics, and how to best identify patients at risk for this common arrhythmia.

Transcript

I had the good fortune of working with a number of basic clinical and population scientists across a number of institutions including Mass General, the Broad Institute, collaborations with the Framingham Heart Study. Our work is really focused on understanding the mechanisms of atrial fibrillation through human genetics, understanding how best to identify patients at risk for atrial fibrillation, and atrial fibrillation morbidity using a number of different techniques including mining the electronic record and improving outcomes in patients who have atrial fibrillation or who we identify with atrial fibrillation through these new mobile health technology platforms.

What we know about atrial fibrillation is that it’s a common morbid arrhythmia associated with substantial economic burden. We now appreciate that the probability of developing atrial fibrillation, if one makes it to the age of 55, is about 37% over the course of their lifetime. Genetic redisposition and clinical respective burden are important variables that explain the variability in atrial fibrillation of risk. Individuals who have the highest burden of genetic predisposition for clinical risk factor burden have approximately 50% chance of developing a-fib over the course of their lifetime whereas those have the lowest genetic or clinical respective burden have only a 20% probability of developing AFib over the course of their lifetime.

In addition, what we've seen is that a healthier lifestyle is associated with a delay in the onset of atrial fibrillation by about seven years among those who have the healthiest risk factor profile.

I think what we now appreciate is that genetic respect of burden plays a substantial role in risk of developing atrial fibrillation and I think as we start to learn more about the genetic basis of atrial fibrillation, we will be able to use that information in a number of ways, one of which is we will be able to better assess risk of individuals for developing atrial fibrillation. We’ll also have a better understanding of the biology of atrial fibrillation and hopefully be able to identify new therapeutic targets for atrial fibrillation, a disease for which we have very limited antiarrhythmic therapies right now.

In addition, with the emergence of mobile technology, we are starting to appreciate the overwhelming burden of atrial fibrillation in the community.

There are a lot of questions we don't have answers to right now about the burden of atrial fibrillation and how it relates to stroke, rather morbidity and how we should best identify those patients and treat those patients when we do identify atrial fibrillation.

Learn more about Mass General's Cardiac Arrhythmia Service

Related

Mass General physicians presented on the podium, moderated sessions or showcased posters over 50 times at the American Heart Association 2017 Scientific Sessions. Some of them answered the question: “What was the most interesting topic presented at this year’s Scientific Sessions?"

Related

Patrick Ellinor, MD, PhD, director of Mass General’s Cardiac Arrhythmia Service, discusses his team’s recent work leveraging genome-wide association studies to identify over 100 different genetic determinants of atrial fibrillation, and his hope of using those variants to develop new drugs to treat atrial fibrillation in the years to come.