Arrhythmias – Which are important and what can you do?
Arrhythmias can be difficult to diagnose in primary care. Dr Frans Rutten (Utrecht, Netherlands) suggested the reasons why GPs find it challenging to manage arrhythmias could be due to the uncertain predictive value of symptoms, the paroxysmal nature of arrhythmias and that an ECG taken at the time of the arrhythmia and accurate interpretation is required for diagnosis. He reviewed the common symptoms and signs of arrhythmias and used the rest of the seminar to review the ‘most common and sustained cardiac arrhythmia’; atrial fibrillation (AF). AF affects 1-2% of the general population and over 10% of people over the age of 80. It is associated with a five fold increased risk of stroke, increased mortality, hospitalisation and reduced quality of life. The importance of checking the pulse was emphasised. ‘As GPs we should always be alert for AF…..so check the pulses of patients over the age of 65 seen in clinic’, said Dr Rutten. The role of rate and rhythm controlling agents was also addressed. ‘The use of rhythm control agents in achieving sinus rhythm needs to be weighed against their proarrhythmic effects and adverse event profile.’
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