Can You Take Ozempic With AFib?
Yes, you can. Currently, there is no evidence of any interaction between Ozempic and atrial fibrillation (AFib).
However, Ozempic can reduce gastric emptying speed [2]. Patients with atrial fibrillation are often treated with anticoagulation tablets, to reduce the risk of strokes [3].
The slower gastric release, caused by Ozempic, means the active substance will come into effect later. This can be relevant in cases where there are longer periods between taking anticoagulation tablets.
What is Ozempic, and what is it used for?
Ozempic, also known as semaglutide, is a medication prescribed for the treatment of type 2 diabetes in adults. It belongs to the group of glucagon-like peptide-1 (GLP-1) receptor agonists. They work by mimicking the action of the hormone called GLP-1, which is naturally produced in the body [4, 5, 6, 7, 8, 9].
The primary function of semaglutide is the regulation of blood sugar levels. Typically, it is prescribed as part of a complex treatment that includes lifestyle changes such as a healthy diet and regular exercise. Ozempic not only regulates sugar levels, but it is also used to reduce the risk of heart-related complications, such as heart attack and stroke, in diabetic patients with heart disease [4, 7].
Interestingly, one of the side effects of the Ozempic is weight loss. While not officially approved, it can be prescribed off-label in the treatment of obesity. Semaglutide decreases appetite, slows down digestion, and makes the brain feel like the stomach is full. All these effects make a person eat less. However, as mentioned, this is considered off-label. The drug was not developed for this reason. [10, 11, 5, 6, 8].
What is atrial fibrillation?
Atrial fibrillation is a common type of heart arrhythmia (abnormal heart rhythm). It is characterized by a desynchronized contraction of the upper chamber of the heart, the atrium. It is caused by abnormal electrical impulses leading to chaotic atrial activation without coordinated contraction. [12, 13, 14].
This irregular rhythm disrupts the normal flow of blood from the atria to the ventricles [13, 15]. Instead of contracting in a coordinated manner, the atria fibrillate. The lack of effective contraction leads to inefficient blood flow [14].
The biggest concern in afib is blood stasis. Culminations of static blood can activate the coagulation leading to formation of blood clots, which can be ejected from the heart. In a situation where a clot leaves the heart, it is not uncommon for it to travel up to the brain, causing a stroke.
AFib is especially common in adults over 65 years old and affects millions in the US alone [13, 16].
Untreated AFib is a serious condition with dangerous complications. It bears a high risk of stroke and in the long run, heart failure [13, 15, 17, 18]. However, individuals with proper management can lead a normal life [13].
Diagnosis and Treatment of Atrial fibrillation
Atrial fibrillation is a common and chronic condition. It affects 2–3% of the population in Europe and the USA. Additionally, it devours up to 3% of healthcare expenditures a year. It leads to complications such as A$stroke!thrombotic-stroke-vs-embolic-strokeA$, sudden death, and heart failure [19].
Diagnosis of Afib
AFib is typically diagnosed based on a 12-lead ECG or 24-hour Holter monitoring [20]. However, AF can also be detected during blood pressure check ups [21], but it has to be later confirmed via the ECG.
Newer technologies to detect afib have been developed. These include pulse palpation, a sphygmomanometer with automated AF detection, and a handheld single-lead electrocardiogram (ECG) [22].
The current AI and mobile health technology revolution in health care, has produced tools that can help with the detection of AFib [23]. Devices like smartwatches can continuously record and evaluate the single-lead ECG of the patient, giving valuable insight into the daily behavior of the heart.
Treatment of Afib
Once diagnosed, AFib has to be treated on multiple levels. This includes treating the acute situation of the patient and the treatment of any other heart diseases.
Long-term therapy is constructed to prevent strokes as well as to control the rhythm and rate of the heart [19]. Proper medication lowers the risk of stroke by around 60% [22].
Rate control and rhythm control strategies are essential for the treatment . Especially in acute conditions in AFib, electrical cardioversion is an important choice in rhythm control strategy. In some cases, like recurring AFib, catheter ablation and cardiac surgery methods can be used [20].
In addition to these, to control both the rhythm and rate, cardiovascular implantable electronic devices (CIED) can be used. pacemakers as well as cardiac resynchronization therapy devices, are a great solution for the long-term treatment of some cases [20].