Atrial fibrillation in Jordan: Symptoms and complications

heart attack
(Photo: Shutterstock and Envato elemente)
With the help of awareness campaigns over the past few decades, the dangers of cardiovascular diseases have become common knowledge. In Jordan, 14 percent of adults between the ages of 45–69 have a history of cardiovascular disease. اضافة اعلان

Cardiovascular-related death is the greatest contributor to global mortality. In Jordan, cardiovascular-related deaths contribute to 39 percent of all mortality.

One cardiovascular disease is atrial fibrillation (Afib), and although it is not inherently deadly, it is highly associated with other fatal conditions. In this article, we share the signs, symptoms, and complications of Afib, as well as the work that has been done on Afib in Jordan.

What is Afib?
The heart is a muscle that depends on perfectly timed contractions to pump blood. It is comprised of four chambers: the upper two atria and the lower two ventricles. Each chamber contracts at a precise time, squeezing the blood and forcing it into the next chamber or the rest of the body.

It is known as an arrhythmia if there is any abnormality in the timing or rhythm of these contractions. There are many causes and types of arrhythmias, but the most common type is Afib. Afib occurs when atria contract irregularly, akin to a quiver, which greatly impacts blood flow into the ventricles.

Afib has different classifications based on cause and duration. Regarding cause, Afib can be divided into valvular and non-valvular classifications. Valvular Afib refers to Afib caused by issues relating to the heart valves, whether it be a disorder or prosthetic. Non-valvular refers to all other causes such as high blood pressure or stress which is the vast majority of all Afib cases.

In relation to duration, Afib can be divided into three types: paroxysmal, which happens seemingly randomly and stops within seven days; persistent Afib, which lasts longer than seven days and may require cardioversion (i.e., electrical shock that restores heart rhythm); and long-standing persistent Afib, which is similar to persistent Afib but lasts longer than a year.

Symptoms of Afib
Afib can manifest in different ways. People may experience symptoms or not experience any at all. Two of the most common symptoms experienced are irregular heartbeats and heart palpitations. An irregular heartbeat can be either too slow, too fast, or inconsistent.

The normal heart rate at rest is between 60–100 beats per minute. This can vary between individuals, but most people can sense when their heart rate has become irregular. For those with Afib, irregular heartbeats are often accompanied by other symptoms and occur frequently. A heart palpitation is when you can feel your heart beating quickly, fluttering, or pounding. These sensations have been described as drums pounding, thunder rumbling, or fish flopping in the chest.
Those with Afib are five times more likely to suffer from stroke, and it is estimated that 15–20 percent of all stroke cases also have Afib.
Afib can be associated with other symptoms, but they are nonspecific and difficult to diagnose. Chest pain is common with arrhythmias but may also indicate other cardiovascular conditions that could be potentially fatal. These symptoms include feeling faint, shortness of breath, and confusion. If you have no previous history of cardiovascular diseases and you experience irregular heartbeats and heart palpitations, especially when combined with symptoms, you should seek medical attention immediately. Since these symptoms are nonspecific, they could indicate a heart attack.

If you are diagnosed with Afib, differentiating between a heart attack and Afib can be more difficult. Generally, if the aforementioned symptoms are combined with excessive sweating or radiating chest pain into the arm or neck, then it may indicate a heart attack. For more information, speak to a doctor on the signs and symptoms to expect once diagnosed with Afib.

Complications of Afib
While Afib itself is not inherently deadly, it can lead to serious complications that can be fatal. One of the greatest risks is the formation of clots. Since blood flow from the atria to the ventricles is impaired, the likelihood of stagnant blood pooling and forming clots increases. This risk only increases when in combination with other factors such as hypertension (i.g., high blood pressure), diabetes, and being older than 65.

The clots formed have the potential to break off and travel to other parts of the body. One of the most common places these clots travel to is the blood vessels that carry blood to the brain. As a result, the clots block blood flow to the brain and cause a stroke. This causes the brain to be starved of oxygen and results in disability or death.

Those with Afib are five times more likely to suffer from stroke, and it is estimated that 15–20 percent of all stroke cases also have Afib.

Another concern of Afib is heart failure. Heart failure occurs when the heart can no longer pump blood efficiently and cannot meet the body’s demands. This relates to atria’s impairment of blood flow to ventricles, ultimately affecting overall blood flow to the body.

Heart failure is chronic and progressive; therefore, it is more commonly seen in those with long-standing persistent Afib.

Afib in Jordan

Western nations have long studied Afib, but little research exists in the Middle East. As a direct result, the Jordan Collaborating Cardiology Group, in collaboration with the Jordan AF Study Group, set out to evaluate Afib patients in multiple medical settings. This project is known as the JoFib Study, and its data has resulted in numerous subsequent studies.

The JoFib study consists of 2,163 Afib patients that enrolled from May 2019 to January 2021, and their outcomes were assessed over a year. The results found by the JoFib study allowed subsequent studies in relation to Jordanians to emerge. One result found that the risk of clots in Jordanian Afib patients, which was 83.9 percent of women and 78.8 percent of men with Afib were at high risk for developing clots.

It was also found that within the one-year follow-up, 7.8 percent of patients had cardiovascular-related death, which was consistent with other global studies which estimate cardiovascular-related death between 4–7 percent.

Another study using data from JoFib wanted to assess the risk associated with Afib and coronary heart disease (CHD). CHD occurs when fat builds up along the walls of the coronary arteries (i.g., the vessels that supply blood and oxygen to the heart).

CHD is a major cause of death globally and is the most common type of heart disease. This study found that 11.35 percent of Jordanian Afib patients also had CHD and that men were at a higher risk for developing it.

One of the main takeaways from the JoFib study and subsequent studies was the risk factors — which are modifiable. The likelihood of developing almost any heart-related condition can be traced back to lifestyle. It is important to have a healthy diet and exercise regularly to control blood pressure and cholesterol while also reducing the risk of diabetes (which increases the risk of cardiovascular diseases).

Avoiding poor lifestyle choices such as smoking or drinking alcohol in large quantities can also greatly reduce the risk of developing or worsening cardiovascular diseases.

Read more Health
Jordan News