Most of us are at least familiar with the term “arrhythmia.” Now, whether or not we really understand what an arrhythmia is, how it functions, or what causes it is an entirely different matter altogether. Imagine being at a dance and instead of gliding across the dance floor in perfect harmony with your partner and the music, you’re always one step off the beat from everyone else – either too fast, too slow, or simply in your own little dance-beat land that makes no sense to you, your partner, and certainly has no relationship at all to the music. The same is true of an arrhythmia: the heart beats too fast, too slow; or simply some place irregular place in between.
Of all the arrhythmias, the most common is an atrial fibrillation. During atrial fibrillation, the upper chambers of the heart – the atria - aren’t able to dance in step with the lower heart chambers – the ventricles. Think of it this way… the atria is auditioning for River Dance while the ventricles and trying out the latest hip hop steps – the result is not good!! Atrial fibrillation gets its name from the rapid, irregular contracting – or fibrillation – that occurs in the atria.
Atrial fibrillation increases the risk of heart failure, premature death, and stroke. Persons with high blood pressure, heart disease, heart failure, structural or congenital heart defects, pericarditis, prior heart attacks, sick sinus syndrome, sleep apnea, obesity, diabetes, and lung disease are more likely to develop atrial fibrillation. In addition to these risk factors, a new study led by Professor Henrik Toft Sorensen at Aarhus University Hospital in Denmark, revealed that commonly used non-selective non-steroidal anti-inflammatory drugs, or NSAIDS and COX-2 inhibitors may lead to an increased risk of developing atrial fibrillation.
NSAIDs are commonly used to treat minor conditions such as fever, menstrual cramps, arthritis, coughs, colds, headaches, and other minor or sports related injuries. In addition, NSAIDS also reduce inflammation. Common NSAIDs include aspirin, Celebrex, Voltaren, Lodine, Motrin or ibuprofen, Indocin, Orudis, Toradol, Relafen, Aleve or Naprosyn, Daypro, Feldene, Clinoril, and Tolectin. With the exception of aspirin, use of NSAIDs has been linked to both heart attack and stroke. Because aspirin prevents blood clots, it’s frequently used by persons at risk for heart attack or stroke as a preventative measure.
Using the Danish National Registry of Patients, Sorensen’s team identified more than 32,600 patients with a first diagnosis of atrial fibrillation over a nine year period from 1999 to 2008. Each identified case of atrial fibrillation was cross-matched and compared with 10 control patients. For purposes of the study, patients were classified into groups of recent NSAID users with the first use being within 60-days of diagnosis, and long-term NSAID users. Researchers found that both NSAID and COX-2 inhibitors increased the risk of atrial fibrillation, 40 and 70 percent, respectively.
While the link between NSAIDs and an increased risk of heart attack and stroke is generally accepted, the link to an increased risk of atrial fibrillation is new information. Researchers recommended that physicians evaluate the impact of taking NSAIDs or COX-2 inhibitors on your total heart health, including risk of atrial fibrillation.
BMJ-British Medical Journal (2011, July 11). Common painkillers linked to irregular heart rhythm. ScienceDaily. Retrieved July 12, 2011, from http://www.sciencedaily.com /releases/2011/07/110705071747.htm
Annette Gbemudu, PharmD, NSAIDS Drugs (Nonsteroidal Antiinflammatory Drugs), RxList, 04 Dec 2008, http://www.rxlist.com/script/main/art.asp?articlekey=94691
What is Atrial Fibrillation, National Heart Lung and Blood Institute, Jul 2011, http://www.nhlbi.nih.gov/health/dci/Diseases/af/af_what.html
Reviewed July 14, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton