In a healthy heart, the rate and rhythm of the heartbeat are controlled by an electrical system.
A series of coordinated electrical signals start in a part of the heart called
the Sinus Node. The electrical impulse then spreads across the heart and tells it when
and where to contract, or squeeze. This synchronized heartbeat continuously circulates blood from
the lungs, through the heart, and out to the rest of the body to deliver oxygen. In people
with atrial fibrillation--also called AFib--the electrical signals are abnormal, and largely
chaotic, and cause the heart's chambers to beat irregularly, and often rapidly. If you
have been diagnosed with AFib, you are not alone. AFib is the most common type of irregular
heartbeat, and an estimated 2.7 to 6.1 million Americans are living with AFib. Some people
with AFib never experience symptoms and are diagnosed when a healthcare professional detects
an irregular heartbeat. It's estimated that one-third of Americans who have AFib, don't
know they have it. So people at risk for AFib should have their heart listened to, and their
pulse checked regularly. Others are diagnosed because they experience symptoms and report
them. Symptoms can include irregular, pounding, or rapid heartbeat, that some people describe
as the feeling of butterflies, or a fish flopping in their chest. Dizziness, fainting, breathlessness,
weakness, fatigue, and chest pain can also occur. These episodes of AFib can be very
frightening, and even disabling. AFib is often classified, and treated, based on how often
the episodes occur. Paroxsymal, or intermittent AFib, is when episodes stop spontaneously,
but don't last more than 7 days. Persistent AFib is when episodes last longer than 7 days.
Longstanding Persistent AFib lasts continuously for more than a year. Permanent AFib is when
episodes last longer than 7 days and where a decision has been made not to stop it. There
are a number of causes and risk factors for AFib including abnormalities in the heart's
physical structure from things like valve problems and previous heart attacks. Other
causes and risk factors include high blood pressure, coronary heart disease, overactive
thyroid or metabolic imbalances, lung disease, previous heart surgery, viral infections,
stress, sleep apnea, and exposure to caffeine, alcohol, and certain medications. Sometimes
the cause is unknown, although it is known that the risk of AFib increases as we age.
Those with AFib have a higher risk for heart failure and stroke, but with proper treatment,
these risks can be managed. Having AFib is certainly not a death-sentence and many AFib
patients enjoy a healthy and active life. You will likely work with a cardiologist,
or cardiac electrophysiologist, to treat your AFib. One of the treatment goals is to prevent
the heart from beating too fast. This rate control can help reduce your symptoms. This
usually can be accomplished with medications like Beta Blockers and Calcium Channel Blockers.
Rhythm control is a related but different treatment approach that allows the heart's
chambers to work together to efficiently pump blood. Your healthcare professional will let
you know whether you might benefit from rhythm control. If so, procedures may be necessary
and include electrical cardioversion, where a controlled shock to the chest restores the
normal rhythm. Catheter ablation where radio frequency, heat, or cryo (cold) energy is
used to strategically destroy tissue and prevent the abnormal electrical impulses from spreading.
Maze, or mini-maze surgery is similar to catheter ablation and may also use incisions to interrupt
the signals. Another critical part of treating AFib is preventing strokes. Because the heart
beats irregularly while in AFib, it affects the way blood flows through the heart and
makes it vulnerable for forming clots. Those clots can travel from the heart to the brain
where they can block vital blood flow and oxygen, resulting in a stroke that can be
debilitating or deadly. The risk of stroke in a person with AFib is 500% higher than
in someone without the disease. So treatment to reduce stroke risk is essential. Anticoagulants,
also called blood-thinners, interfere with the body's clotting mechanisms, and reduce
the risk of stroke. There are now a number of oral anticoagulants available that work
in different ways, with different benefits and risks, allowing the healthcare professional
and patient to choose the right drug for them. Some individuals may not need an anticoagulant
because their risk of stroke is so low, or because their risk of bleeding as a side-effect
of the anticoagulant is too high. However, fatal bleeding while on an anticoagulant is
rare, and for most AFib patients the benefit of preventing AFib-caused strokes outweighs
the increased risk of bleeding. In most cases, things like frailty, age, and risk of falls
should not be barriers to anticoagulation. If you have been diagnosed with AFib, being
a proactive member of your healthcare team is critical to effectively managing your condition.
Partner with your healthcare professional in making treatment decisions. This can be
confusing and overwhelming, so never hesitate to ask questions and get the information you
need. Keep all your medical appointments and take your medications as directed. Don't stop
or switch any medications without talking with your healthcare professional. Discuss
your diet and any over-the-counter medications that could interfere with your treatment.
Continue to exercise with the guidance of your healthcare professional. AFib can cause
increased fatigue, but it does not have to eliminate your activities. Be sure to report
any changes in your health or symptoms. Getting an AFib diagnosis can be frightening and even
confusing, but it is a manageable condition and you can expect to live a healthy and active
life by partnering with your healthcare professional, and following the treatment plan that is right
for you. To learn more about stroke risk reduction for people with AFib watch Preventing Stroke
from Atrial Fibrillation on YouTube and visit www.agingresearch.org/atrialfibrillation.
Brought to you by the Alliance for Aging Research.