Prevention of Atrial Fibrillation. Karin Prussak, DNP, ARNP Florida ACC August 17, 2013. Objectives. Evaluate the economic burden of AF List the most common risk factors of AF. Identify risk factor modification to decrease risk of AF based on current research studies.
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Prevention of Atrial Fibrillation
Karin Prussak, DNP, ARNP
August 17, 2013
legislation, which includes an optional public insurance program
H.R. 3590 authors project that 94% of the U.S. population will have health coverage and does not include a public insurance option
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$6.65 billion in total treatment costs:
Hospital: $4.88 billion
Outpatient: $1.53 billion
Medications: $235 million
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Valvular Disease (RHD)
Coronary Artery Disease
Obstructive Sleep Apnea
Cardiothoracic surgery: CABG and valvular surgery
Previous episodes of AF
Wu et al., 2005; Chen & Shen, 2007; Gami et al., 2007; Lip et al., 2007; Watanabe et al., 2008; Fuster et al., 2006; Otway, Vandenburg & Fatkin, 2007.
Atrial fibrosis and loss of muscle mass
Expression of angiotension-converting enzyme increased 3-fold during persistent AF
Increase in left ventricular hypertrophy led to increase in left atrial dimension which increases the risk of AF
Atrial stretch can cause AF and AF can cause atrial dilation
Autonomic Nervous System activity
LV diastolic dysfunction affects stretch receptors in the pulmonary veins or directly affects atrial myocardium.
Increased Left Atrial Diameter (LAD)
New Onset Atrial Fibrillation
Left Ventricular Enlargement or Hypertrophy
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Fuster, et al. 2006.
Risk of AF increased 5% for each one unit increase in BMI.
Significant difference noted in LAD in obese men compared to overweight men (p<.001).
Increased risk of AF with increased LAD and LVH.
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Anti-oxidant and Anti-inflammatory
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