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Dr. Anthony Pearson, St. Luke's Hospital

Differences exist in the likelihood of symptoms and the treatment of atrial fibrillation in women

Atrial fibrillation is the most common heart rhythm abnormality in the United States today. It is a major cause of stroke, disability and death and is equally prevalent in both men and women. Women often don't realize that they can be at risk for atrial fibrillation since, in the past, these complications have mainly been associated with men.

Atrial fibrillation is a condition where the upper chambers of the heart (atria) are beating chaotically and ineffectively, resulting in a rapid and irregular heart rate. This causes ineffective cardiac performance and symptoms including palpitations, shortness of breath, fatigue and/or chest pain. Women are more likely than men to have these symptoms.

Effective treatment methods currently available include the utilization of medications, surgery or catheter-based techniques, and they may be applied differently depending on one's gender.

Stroke is the most serious complication of atrial fibrillation and occurs when clots form in the dysfunctional left atrium. We know that certain factors including advanced age, hypertension, heart failure, diabetes and a prior stroke increase that risk. Safe and effective medications including warfarin and two newer agents, Pradaxa and Xarelto, are now available and reduce the risk of stroke in people with atrial fibrillation by 60 to 70 percent. Studies suggest that women may be at higher risk for these strokes and benefit more from blood thinning agents.

While women tend to be more symptomatic from atrial fibrillation than men, they fare worse than men when a rhythm-control strategy is utilized with anti-arrhythmic medications. The reasons for this are not entirely clear, but women seem more susceptible to the development of more dangerous heart rhythms from certain drugs (anti-arrhythmic drugs) used to maintain a normal rhythm. They are also more likely to have slow heart rhythms that may require a pacemaker.

If you are a woman with atrial fibrillation, you should take this condition very seriously and carefully weigh your options, even if you are totally free of symptoms. The most important factor in safe and effective treatment is to make sure you see a cardiologist with expertise in the treatment of atrial fibrillation who will individualize and monitor therapy based on your age, gender and other important factors.

Dr. Anthony Pearson is a board-certified cardiologist at St. Luke's Hospital. To learn more information or to schedule a consultation for atrial fibrillation, call (314) 205-6699.

This article was published in the St. Louis Post-Dispatch on February 23, 2012.

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