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June 1, 2022

September is National Atrial Fibrillation Awareness Month

Facts

  • By the year 2030, it is projected that 12.1 million Americans will have atrial fibrillation (AFib).1
  • Atrial fibrillation contributes to approximately 158,000 deaths annually. This number has been rising over two decades.1
  • Approximately one in every five cases of AFib is related to a diagnosis of high blood pressure.1
  • Approximately 22% of all strokes are related to atrial fibrillation.2
  • AFib causes around one in every seven strokes.1
  • In individuals over the age of 80, AFib causes one in every four strokes.3
  • AFib places a person at an estimated five times greater risk of having an ischemic stroke.1

September is National Atrial Fibrillation Awareness Month. This month focuses on educating the public on the diagnosis and treatment of atrial fibrillation. It also includes identification of risk factors that may lead to atrial fibrillation as well as prevention techniques to promote a healthy heart and healthy lifestyle.

Atrial fibrillation is a the most common type of cardiac arrythmia. Patient with AFib present with an irregular heart rhythm and a faster than normal heart rate.

Signs and Symptoms
Signs and symptoms include heart palpitations, irregular heartbeat, fatigue, chest pain, shortness of breath, dizziness/lightheadedness, fainting, and low blood pressure. However, some people may be asymptomatic and therefore unaware that they have AFib.

Risk factors
Risk factors for atrial fibrillation may include but are not limited to increased age, family history, obesity, smoking, moderate to heavy alcohol use, stress, and presence of pre-existing medical conditions (high blood pressure, diabetes, hyperthyroidism, heart disease, heart failure, sleep apnea, and chronic kidney disease).

Complications
Complications of AFib include blood clots, CVA (stroke), myocardial infarctions, heart failure, and cognitive impairment/dementia.

Screening and Diagnosis
Screening and testing are performed to diagnose AFib as well as rule out other conditions that present with similar signs and symptoms. Screening and testing interventions may include auscultation of the heart, palpation of the pulse, electrocardiogram (EKG/ECG), Holter monitor, event monitor/recorder, echocardiogram, stress test, blood work, and chest X-ray.

Treatment
Goals include managing the heart’s rate and rhythm, preventing complications from AFib from developing, preventing clots from forming, and managing overall AFib risk factors.

Treatment may include:

  • Medications
  • Cardioversion
  • Medical/surgical procedures, such as catheter ablation, surgical ablation (Maze procedure), placement of atrial pacemaker, and closure of the left atrial appendage
  • Lifestyle modifications

Prevention
There are several steps you can take to promote the health of your Medicare beneficiaries.

  • Encourage your patients to schedule annual wellness visits and health screenings.
  • Talk to your patients about heart health including risk factors for cardiovascular disease.
  • Educate your patients on healthy habits such as exercising, eating a well-balanced diet including foods that are low in salt, fat, and cholesterol, lowering stress levels, limiting or refraining from caffeine use, controlling weight (or losing weight if needed), and getting enough sleep.
  • Encourage your patients to refrain from or to limit use of alcohol. Discuss with your patients the link between alcohol use, cardiovascular disease, and the risk of atrial fibrillation.
  • Encourage your patients to quit smoking. Instruct your patients on the effects of smoking and the link between smoking, cardiovascular disease, and the risk of atrial fibrillation. Medicare covers counseling to prevent tobacco use for those patients who qualify. Discuss this Medicare covered benefit with your patients and encourage them to enroll.
  • Educate your patients on the signs and symptoms of a CVA (cerebrovascular accident)- also known as a stroke.
    • F- Face (Ask the person to smile and look for one-sided facial drooping.)
    • A-Arms (Ask the person to raise both arms and look for one-sided arm drifting.)
    • S- Speech (Ask the person to say a simple phrase and note for slurring or unusual speech.)
    • T-Time (Call 9-1-1 if any of the above signs are present. Note the time when the signs/symptoms first occurred.)
    • Please note- the acronym B.E F.A.S.T. may also be used when determining the signs and symptoms of a stroke.6  The B stands for Balance (difficulty with balance or coordination) and the E stands for Eyes (sudden loss of vision in one of both eyes ; sudden onset of blurry vision or diplopia).
  • Monitor your patients’ blood pressure levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood pressure, cardiovascular disease, and the risk of atrial fibrillation.
  • Medicare covers Cardiovascular Disease Screening Test,  Intensive Behavioral Therapy (IBT) for Cardiovascular Disease, and Intensive Behavioral Therapy (IBT) for Obesity for those patients who qualify. Discuss this Medicare covered benefits with your patients and encourage them to enroll if applicable.
  • If your patients are diabetic, monitor their blood glucose levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood glucose levels, cardiovascular disease, and the risk of atrial fibrillation.
  • If your patients are prescribed preventive medications (such as anti-platelet drugs and anticoagulants) or currently on cardiovascular or diabetic medications, review the importance of regularly taking medications. Address any questions they may have regarding the medications prescribed, including safety precautions while taking these medications.

To learn more about Medicare-covered services, visit CMS Preventive ServicesExternal Website

For More Information

CMS.gov and Medicare.gov Resources

Other Resources

References

  1. Atrial Fibrillation | cdc.gov. (2021, September 27). Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/atrial_fibrillation.htmExternal Website
  2. stopafib. (2021, July 13). Stroke Risks From Atrial Fibrillation — StopAfib.org. https://www.stopafib.org/learn-about-afib/why-is-afib-a-problem/stroke-risks-from-afib/External Website
  3. Atrial Fibrillation and Stroke Information Page | National Institute of Neurological Disorders and Stroke. (2022, April 1). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Atrial-Fibrillation-and-Stroke-Information-PageExternal Website
  4. Atrial Fibrillation - What Is Atrial Fibrillation? | NHLBI, NIH. (2022, March 24). National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/atrial-fibrillationExternal Website
  5. Atrial fibrillation - Symptoms and causes. (2021, October 19). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624External Website
  6. Know the Signs of Stroke - BE FAST | Duke Health. (2021, September 23). Duke Health. https://www.dukehealth.org/blog/know-signs-of-stroke-be-fastExternal Website

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