Predicting Risk Of Heart Rhythm Problems Using Your Genes

Michael Rosenberg, M.D. Assistant Professor, Division of Cardiology, University of Colorado School of Medicine

Atrial fibrillation, or an irregular heartbeat, is the most common cardiac arrhythmia disorder, and impacts millions of patients worldwide. The primary concern about atrial fibrillation is that it can cause strokes due to the formation of blood clots in the heart. This risk can be reduced to less than 1% per year if a patient with atrial fibrillation is started on blood thinners, but unfortunately, many patients are not aware of having atrial fibrillation until the time of a stroke. For that reason, many researchers, including those on the University of Colorado Anschutz Medical Campus, have been focused on finding new ways to identify patients who might be at risk of atrial fibrillation before they have a stroke.

We now know of hundreds of genes that can affect the risk of atrial fibrillation. Researchers have learned to combine all of this genetic information into a risk score called a polygenic risk score (PGS), which can be used to determine the ‘genetic risk’ for a given patient. In order to calculate a PGS for a single patient, clinicians need to have a source of all genotype information for that patient, which is where the Colorado Center for Personalized Medicine (CCPM) Biobank comes in. The CCPM Biobank is genotyping blood samples from participants. With this information, we can calculate the PGS for atrial fibrillation (as well as many other conditions) to determine risk of atrial fibrillation.

Decades ago, little could be done with knowledge about a patient’s risk of atrial fibrillation, genetic or otherwise. However, recent advances in wearable heart monitors have created the opportunity for researchers to do more screening in patients who might be at a higher risk for atrial fibrillation. For one, there are watches that include an electrocardiogram (EKG) monitor that can be used to determine if that person has atrial fibrillation. Second, a wearable patch can be attached to the chest for up to 2 weeks and then mailed back to provide information about a patient’s heart rhythm over time. Finally, tiny implantable heart monitors can be inserted into the chest of a patient to give up to 3 years of continuous monitoring in order to detect atrial fibrillation, or other heart rhythm problems.

Here on the Anschutz Medical Campus, researchers are developing programs to combine these exciting technologies with genetic information obtained from Biobank participants in order to prevent strokes in patients who might be at risk of atrial fibrillation. Stay tuned for opportunities to participate in this exciting research that aims to combine technology improvements and genetics to improve outcomes for our patients.