US Senate Unanimously Endorses Campaign Against Atrial Fibrillation 7

On a day when Americans watched nervously as its government sought to contend with unprecedented turmoil and peril in the economic and political life of the country, the US Senate put aside all divisions and partisan politics to act decisively and unanimously to express support for “promoting increased awareness, diagnosis and treatment of atrial fibrillation.”

Senate Resolution 243 is intended “to address the high morbidity and mortality rates and to prevent avoidable hospitalizations associated with the disease.” A corresponding resolution, H. Res 295, has been introduced in the house, and has received support from the  disease-mongering patient-advocacy group StopAfib.org and an unqualified endorsement from the Heart Rhythm Society (click here, here, and here for links to the ProPublica investigation of the deep influence that industry exerts on HRS).

I am not aware of any previous expression of concern by the House or the Senate about AF. It is surely no accident that two new AF drugs have been approved recently and more are on the way.

(Editor’s Note to readers: Don’t forget to check out the terrific comments at the bottom of this post.)

Here is the entire bill:

S. Res. 243

Promoting increased awareness, diagnosis, and treatment of atrial fibrillation to address the high morbidity and mortality rates and to prevent avoidable hospitalizations associated with the disease
Whereas atrial fibrillation is a cardiac condition that results when the usual coordinated electrical activity in the atria of the heart becomes disorganized and chaotic, hampering the ability of the atria to fill the ventricles with blood, and allowing blood to pool in the atria and form clots;

Whereas an estimated 2,500,000 people in the United States are living with atrial fibrillation, the most common “serious” heart rhythm abnormality that occurs in people older than 65 years of age;

Whereas atrial fibrillation is associated with an increased long-term risk of stroke, heart failure, and all-cause mortality, especially among women;

Whereas people older than 40 years of age have a 1-in-4 risk of developing atrial fibrillation in their lifetime;

Whereas an estimated 15 percent of strokes are the result of untreated atrial fibrillation, a condition that dramatically increases the risk of stroke to approximately 5 times more than the general population;

Whereas atrial fibrillation accounts for approximately 529,000 hospital discharges annually;

Whereas atrial fibrillation costs an estimated $3,600 per patient for a total cost burden in the United States of $15,700,000,000;

Whereas better patient and health care provider education is needed for the timely recognition of atrial fibrillation symptoms;

Whereas an electrocardiogram is an effective and risk-free screen for heart rhythm irregularities and can be part of a routine preventive exam;

Whereas there is a dearth of outcome performance measures that focus on the management of atrial fibrillation; and

Whereas evidence-based care guidelines improve patient outcomes and prevent unnecessary hospitalizations for individuals with undiagnosed atrial fibrillation and for patients once atrial fibrillation is detected: Now, therefore, be it

Resolved, That it is the sense of the Senate that the Secretary of Health and Human Services should work with leaders in the medical community to explore ways to improve medical research, screening and prevention methods, and surveillance efforts in order to prevent and appropriately manage atrial fibrillation, including by–

(1) advancing the development of process and outcome measures for the management of atrial fibrillation by national developers;

(2) facilitating the adoption of evidence-based guidelines by the medical community to improve patient outcomes;

(3) advancing atrial fibrillation research and education by–

(A) encouraging basic science research to determine the causes and optimal treatments for atrial fibrillation;

(B) exploring development of screening tools and protocols to determine the risk of developing atrial fibrillation; and

(C) enhancing current surveillance and tracking systems to include atrial fibrillation; and

(4) improving access to appropriate medical care for patients suffering from atrial fibrillation by encouraging education programs that promote collaboration among the Federal health agencies and that increase public and clinician awareness of atrial fibrillation, including risk assessment, screening, treatment, and appropriate clinical management.

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7 comments

  1. Interesting in the context of the perilous arrythmias caused by Congress itself.

    It would, indeed, be interesting to learn more about the relationships between the genesis of this resolution and the intensive maketing of recently approved drugs.

    hg

  2. Is this what a US Congress was meant to serve?

    Bipartisan support for a single disease entity by a congress which has ignored all other public health measures such as Universal access to health care and affordable drugs (Medicare bargaining with PhRMA). What does this mean?

    They are not jumping on the band wagon to endorse AFib care for those only with the means to pay for drugs such as Multaq which is equal to placebo (as long as one does not have CHF or abnormal renal function in which instance it is actually worse than taking sugar lablets), or research by HRS whcih is 50% funded by the makers of me-too drugs. Say its not so.

    If they (US Congress) are such “goody-two-shoes” the next step is a formulary that has to exclude unproven snake oil remedies and a task force to look at exactly how successful RFA is and in whose hands it actually works.
    If they are really serious lets now see a Public Option for A Fib patients.
    Hee hee haw haw! Dont hold your breath.

    Wilbur Larch MD, FACC

  3. At first blush it seems like more tomfoolery — but in reality these resolutions cost significant dollars for the lobbying effort involved, and that kind of use of precious resources shows how distorted the system has become.

    The Multaq story needs a longer discussion, but who in their right mind would prescribe it after the PALLAS trial was stopped? I’d love to be enlightened as to the rationale for the recommendation to continue its use for paroxysmal AF. I worry this represents the triumph of the cult of the clinical trial over common sense.

    • The Pallas trial was looking at chronic afib patients. The use of and safety of Multaq in paroxysmal afib is well studied in the Euridis/Adonis trials and the Athena trials. Many patients have received much benefit from Multaq to date. No other AAD has shown benefit in the chronic type of Afib. The question should be ” Why was this chronic afib population studied in the first place ?”. The safety and efficacy of Multaq in paroxysmal afib is proven. Just ask one of the thousands of patients taking it to date.

  4. In addition there is a great need for education when it comes to this most common heart condition. Untreated it cost our government millions of dollars a year, not to mention the personal suffering of the patient due to the long term effects of untreated afib. The medical community is in need of more studies to uncover the cause and effects of afib and better treatment algorythms for managing this disease state. The Affirm trial left many unanswered questions, and patients need more answers.

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