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  • A new study finds specific genes may predict the risk of a person developing atrial fibrillation or Afib.
  • Afib is linked to tens of thousands of deaths every year.
  • Researchers looked at data from nearly 1,300 people over a 10-year period.

According to the Centers for Disease Control and Prevention (CDC), atrial fibrillation, also called AF or Afib, is the most common type of treated heart arrhythmia.

The agency reports that in 2019, Afib was mentioned on 183,321 death certificates and was the underlying cause of death in 26,535 of those deaths.

New research published this week in the Journal of the American Medical Association (JAMA) finds specific genes are present in people younger than 66 years who develop the condition known as early-onset atrial fibrillation (EOAF).

“How I really became interested in studying this group,” study author M. Benjamin Shoemaker, MD, explained in an interview with JAMA Cardiology. “Was that almost 20 years ago, the first case reports and case series began emerging where families with a strong history of atrial fibrillation were found to have rare variants in genes that we know are associated with traditional inherited cardiomyopathy syndromes.”

“These other syndromes can be really serious causing heart failure and sudden death,” he continued.

The study included 1,293 participants with Afib diagnosed before 66 years of age who underwent whole-genome sequencing.

All were enrolled in the study from November 23, 1999, to June 2, 2015, and averaged 56 years old when the study began.

Researchers found rare genetic variants in 10 percent of them.

During the study, 17 percent of participants died in the next 10 years on average. Mortality among patients with the most prevalent genes with disease-associated variants was 26 percent.

“The findings suggest that rare variants in cardiomyopathy and arrhythmia genes may be associated with increased risk of mortality among patients with early-onset AF, especially those diagnosed at a younger age,” the study authors wrote.

They emphasized that genetic testing may offer important information about Afib risk for patients diagnosed with EOAF, especially at younger ages.

“Genetic testing should not be performed in all patients with atrial fibrillation,” David S. Park, MD, PhD, cardiac electrophysiologist and assistant professor of medicine at NYU Langone’s Heart Rhythm Center, told Healthline.

However, he added that it could be considered in patients diagnosed with Afib at a young age or who have a family history of early-onset atrial fibrillation (EOAF) and associated cardiomyopathy, sudden death, or early pacemaker implantation.

“This study demonstrates that in younger patients (less than 66 years old) presenting with atrial fibrillation,” said Park. “A rare genetic variant that is considered pathogenic or likely pathogenic was found in 10 percent of the study population.”

“Atrial Fibrillation is what we call a sustained, irregular heartbeat,” said Joshua Yamamoto, MD, a cardiologist at Foxhall Medicine and author of You Can Prevent a Stroke.

He pointed out the condition is “exceedingly common” and best thought of as part of the natural aging process.

“Only one percent of 50 year-olds have it, but 30 percent of 70 year-olds have Afib,” continued Yamamoto. “For most people, it is largely asymptomatic for a long time.”

He explained that two major factors that lead to Afib in older people are higher blood pressure and a natural decline in the heart’s “tempo,” which are inevitable with age.

Richard Becker, MD, director of the Heart, Lung and Vascular Institute at the University of Cincinnati College of Medicine said the Afib treatment is increasingly atrial fibrillation ablation.

This procedure uses radiofrequency waves and special tools to identify one or more areas within the heart from which the heart rhythm abnormality originates.

“There are medications that can be used to prevent atrial fibrillation and others that slow the heartbeat toward a more normal rate,” he added. “Blood thinning medications are particularly important to reduce the risk of a stroke.”

According to Christopher Davis, MD, a cardiologist at Reveal Vitality, the risk of atrial fibrillation could be reduced by certain lifestyle changes.

They include avoiding excessive caffeine consumption, controlling blood pressure with either lifestyle changes or medication, and treating underlying sleep apnea.

“Other lifestyle changes include optimizing micronutrients such as magnesium which also play an important role in heart rhythm disturbances,” he said.

“Learning good stress management techniques will also help with overproduction of ‘stress hormones’ that can result in atrial fibrillation,” he continued.

He said while there is a greater risk with specific gene variants, in most cases, it’s lifestyle factors that determine if those genes are expressed.

“Understanding the genetic predisposition for any condition, including atrial fibrillation, is very helpful,” said Davis. “However, having a particular gene itself does not relegate a patient to having a particular condition.”

Davis pointed out that lifestyle medications and environmental factors can affect how your genes function, a process called epigenetics.

“It’s very important to understand these epigenetic modifiers that can help influence the expression of genetic variants,” he said.

Researchers have discovered certain genes strongly associated with a diagnosis of early-onset atrial fibrillation – a potentially fatal condition.

Experts say being screened for these genes may benefit some people, mostly those with a strong family history or who have already been diagnosed with Afib at a young age.

They also say that lifestyle can significantly reduce the risk of developing this condition in people who have these genes.