STARS News & Events
EHRA 2021: Key findings for people with arrhythmias
The European Heart Rhythm Association (EHRA) annual meeting is a European medical congress focused on the management of arrhythmias (heart rhythm disorders). This year, because of ongoing COVID-19 restrictions, it was held online between 23rd and 25th April. While the congress is aimed at healthcare professionals, several of the presentations and studies may be of interest to people with arrhythmias.
Cannabis users with an arrhythmia more likely to die in hospital
In a study, presented at EHRA 2021, Dr Sittinun Thangjui (Bassett Healthcare Network, Cooperstown, USA) and colleagues found that a cannabis user was more than four times likely to die in hospital if they had an arrhythmia compared with a cannabis user without an arrhythmia. Dr. Thangjui said: “Our study highlights that heart rhythm disorders may be a warning sign for an increased risk of death in people who use cannabis. More studies are needed to confirm our results. In the meantime, it seems sensible to screen these patients for arrhythmias if they present to hospital so that those with a heart rhythm problem can be closely monitored.”
Simple foot test could be used DETECT AF in people with diabetes
Dr Ilias Kanellos (European University of Cyprus, Nicosia, Cyprus) and colleagues found that annual foot assessments for people with diabetes may be a good opportunity to DETECT atrial fibrillation (AF). Two podiatrists, and six podologists, were trained to check for an irregular rhythm while performing pulse palpation of the foot arteries of people with diabetes, and they were also shown how to confirm their findings using a hand-held Doppler ultrasound device.
Of 300 people with diabetes attending an annual foot screening appointment (important for detecting complications of diabetes), over a 12-month period, 51 patients (17%) were found to have possible (previously undiagnosed) AF. These patients were then advised to visit a cardiologist for an electrocardiogram (ECG) to reinforce the diagnosis and discuss management.
“In our study, one in six patients with diabetes had previously undiagnosed AF. This presents an opportunity to provide treatment to prevent subsequent [AF-related] strokes,” says Dr Kanellos.
AF is often asymptomatic (without symptoms) and sometimes can only be detected with a pulse rhythm check. Detection is very important because without the right therapies, a person with AF may be five times more likely to have a stroke.
For more information about how to DETECT AF, visit www.KnowYourPulse.org
More than 10% of people develop anxiety or depression after having an ICD fitted
According to Professor Susanne Pedersen (Odense University Hospital, Denmark) and colleagues, people who have an implantable cardioverter defibrillator (ICD) should be regularly screened for anxiety and depression. They found that of 1,040 people with an ICD, who answered questionnaires on anxiety, depression, and physical quality of life, 14.5% developed new-onset anxiety and 11.3% developed new-onset depression over a 24-month follow-up period.
Professor Pedersen comments: “Most patients adapt well to living with an ICD. For others it completely changes their life, with worries about shocks from the device, body image, and livelihood as some need to change their job… Our results suggest that more regular screening for depression and anxiety could identify patients who might benefit from additional support
For more information about living with an ICD, download our “Devices for an arrhythmia booklet” booklet.
New project to explore using AI to better select people for ICDs
As outlined at EHRA, a new project is to review using personalised treatment and artificial intelligence (AI) to better select people for an implantable cardioverter defibrillator (ICD). According to a press release, the project aims to personalise prevention of sudden cardiac death after a heart attack (myocardial infarction) by developing a prediction model. Data from several hundred thousand heart attack patients across Europe, the USA and Israel are being analysed using traditional statistical methods and AI to create a clinical prediction model for the individual risk of sudden cardiac death.
A defibrillator implantation strategy based on the predicted individual risk for sudden cardiac death will then be tested in two clinical trial, including more than 3,900 patients in total.
Principal investigator Dr Nikolaos Dagres says: “The current method of selecting patients for a defibrillator has substantial limitations. In absolute numbers, most sudden cardiac deaths occur in patients with moderately reduced or preserved ejection fraction (above 35%) yet they are left unprotected because they do not qualify for defibrillator implantation according to current guidelines. In addition, as a result of better medical and interventional treatment of myocardial infarction, only a minority of patients who currently qualify for an ICD will ever require it yet may experience unintended shocks or complications associated with the device. Taken together, we clearly need to better select the patients who would benefit from this life-saving therapy… The goal [of the new project] is to reshape the decision making of defibrillator therapy so that those who need it get it, but those who do not need it do not.”