New research advocates genetic screening in early onset atrial fibrillation

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Although nan immense mostly of clinicians do not position atrial fibrillation (AF) arsenic a familial disorder, a White Paper successful nan Canadian Journal of Cardiology, published by Elsevier, analyzes nan existent knowing of genetics and nan domiciled of familial testing successful AF and concludes location is an expanding appreciation that familial culprits for perchance life-threatening ventricular cardiomyopathies and channelopathies whitethorn initially coming pinch AF.

AF is nan astir communal sustained cardiac arrhythmia and is associated pinch accrued risks of bosom failure, stroke, and death. It is not traditionally considered to beryllium a heritable shape of bosom disease, however, a increasing assemblage of lit complete nan past 25 years has shown that genetics lend importantly to susceptibility for arrhythmias, including AF.

Our knowing of nan genetics underlying AF remains successful nan comparatively early stages, though it has go clear that nan mostly of cases apt create secondary to a analyzable relationship betwixt biology and familial contributors. In a number of AF cases, powerful azygous uncommon familial variants tin beryllium nan superior drivers of arrhythmia development.

Beyond accounting for why AF has developed, recognition of these powerful azygous familial culprits tin beryllium important because – successful summation to AF – galore tin besides origin life-threatening ventricular cardiomyopathy and channelopathy syndromes. At present, it remains unclear why nan aforesaid familial version whitethorn manifest pinch AF successful isolation, a ventricular cardiomyopathy/channelopathy syndrome, aliases both.

Lead writer of nan White Paper Jason D. Roberts, MD, MAS, Population Health Research Institute, McMaster University, and Hamilton Health Sciences, says, "Given this recognition, we urge that each early onset AF cases acquisition observant objective screening for grounds of a co-existing ventricular cardiomyopathy aliases channelopathy syndrome associated pinch a consequence of abrupt cardiac death. Should 1 beryllium identified, due familial testing for nan ventricular syndrome is recommended."

Coauthor Rafik Tadros, MD, PhD, Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, adds, "In nan absence of objective grounds of a co-existing ventricular cardiomyopathy aliases channelopathy syndrome, familial testing whitethorn beryllium considered successful early onset AF cases, peculiarly if location is simply a affirmative family history and an absence of accepted objective consequence factors. However, clinicians should beryllium alert that nan output of familial testing successful these instances is anticipated to beryllium debased (<10%), and this should only beryllium pursued successful settings equipped to construe and appropriately negociate familial testing results."

Dr. Roberts states, "The immense mostly of clinicians do not position AF arsenic a familial upset and, isolated from for definite specialty clinics, objective familial testing for AF is seldom performed. The conception that AF whitethorn person underlying familial contributors will hopefully promote clinicians to execute observant family histories, peculiarly successful early onset forms of nan information wherein familial contributors whitethorn beryllium much prominent. Recognition that AF whitethorn perchance originate secondary to familial variants that tin besides origin life-threatening ventricular arrhythmia and cardiomyopathy syndromes will hopefully guideline clinicians to cautiously clinically surface for these conditions, peculiarly successful early onset AF cases that create successful nan absence of identifiable objective consequence factors."

This White Paper was written by a group assembled by nan CCS AF Guidelines Committee, which judged that nan area of objective exertion of AF genetics merited peculiar consideration. The penning group consisted of nan chairs of nan astir caller AF Guidelines Committee, on pinch experts successful objective arrhythmia genetics and AF pathophysiology.

Source:

Journal reference:

Roberts, J. D., et al. (2024) Clinical Genetic Testing for Atrial Fibrillation: Are We There Yet?. Canadian Journal of Cardiology. doi.org/10.1016/j.cjca.2023.11.022.

Posted in: Medical Research News | Medical Condition News

Tags: Arrhythmia, Atrial Fibrillation, Cardiology, Cardiomyopathy, Genetic, Genetic Disorder, Genetics, Heart, Heart Disease, Heart Failure, Pathophysiology, Research, Stroke, Sudden Cardiac Death, Syndrome

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