Things You Need to Know About A-Fib

By Ernst Lamothe Jr.

It’s a condition that results in more than 454,000 hospitalizations in the United States each year. Even worse, the Centers for Disease Control and Prevention predict around 12.1 million people could be diagnosed with the ailment by 2031. Atrial fibrillation — or a-fib — is an abnormal heart rhythm from the top chambers of the heart. This often causes the heart to beat irregularly and quickly. The risks resulting from atrial fibrillation include stroke, heart failure and other heart-related complications.

“Upwards of six million Americans have atrial fibrillation,” said physician James Gallagher, an electrophysiologist with UR Medicine Cardiac Care in Rochester.

He explains five things you should know about a-fib.

1.Symptoms

Atrial fibrillation often presents with racing heartbeats, irregular heartbeats and a lack of stamina. However, many patients have no symptoms, particularly those whose heart rates are not as fast when they are in atrial fibrillation. Other symptoms include lightheadedness, extreme fatigue, shortness of breath and chest pains. A normal heartbeat begins with one electrical impulse from the sinus node, a single point in the heart’s right atrium. A healthy person’s heart usually beats 60 to 150 beats per minute. With a-fib, electrical impulses fire from multiple sites in both atria. That can cause the atria to contract 400 or more times per minute. The ventricles become overwhelmed trying to keep up with the contractions.

“Sometimes the alert for patients to see the doctor is when an at-home blood pressure monitor shows an irregular heartbeat. Checking your blood pressure regularly not only helps screen for high blood pressure, but also a rhythm problem such as atrial fibrillation,” said Gallagher.

“Don't ignore the symptoms of your heart or the findings on your blood pressure monitor.”

If a clot breaks off and enters the bloodstream and lodges in an artery leading to the brain, a stroke results. About 15% to 20% of people who have strokes have this heart arrhythmia. This clot risk is why patients with this condition are put on blood thinners.

2.Prevention

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Episodes of atrial fibrillation may come and go. Or, they may be persistent. However, even though the condition isn’t always life-threatening it has the possibility of leading to more serious medical conditions that require proper treatment.

3.Family history

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A healthy lifestyle with regular aerobic exercise and a well-balanced diet helps reduce your risk of atrial fibrillation and other forms of heart disease. Exercise works like beta-blocker medication to slow the heart rate and lower blood pressure at rest and also when exercising. A combination of aerobic workouts including walking, running, swimming, in combination with strength training, remains the ideal combination for great heart health. High blood pressure is a major risk factor for heart disease. In addition, experts recommend avoiding tobacco and smoking. Whether it’s your eating habits leading to diabetes or the way you handle your environment leading to stress and high blood pressure, Gallagher also suggests making sure to monitor those aspects of life. “Obesity and sleep apnea are associated with atrial fibrillation,” said Gallagher. “Lower your risk by maintaining a healthy weight and using a continuous positive airway pressure machine, if recommended

Family history can play a role in atrial fibrillation. Certain genes have been identified as associated with atrial fibrillation. If you have familial atrial fibrillation, you may get it earlier in life than do those without a family history of the condition.

“There is ongoing research to better understand this, but at this point, we do not have gene-altering treatments for atrial fibrillation,” said Gallagher. “It is not uncommon to see someone who develops atrial fibrillation at a young age to also have a family member who had atrial fibrillation at a young age.

Asian and Black populations see lower atrial fibrillation rates than those of European ancestry.”

4.Misconceptions

A common misconception about atrial fibrillation is that a pacemaker is the first and best therapy. A pacemaker does not keep the heart beating regularly. It increases the heart rate.

“When the heart is beating irregularly, medications and ablation procedures can be used to restore a normal rhythm,” said Gallagher. “However, longtime use of the medications can slow the heart rate dramatically and many people with atrial fibrillation receive pacemakers later.”

5.Climbing upwards

Atrial fibrillation incidence is climbing. While no single cause links to atrial fibrillation, the possibility does increase as you age. “While some risk factors are not able to be modified, such as age and genetics, some risk factors for atrial fibrillation can be modified to try to decrease the chances of this occurring,” he added.