Atrial fibrillation, also called AFib, is an irregular, and often, rapid heart rate and is the most common abnormal heart rhythm among older adults. An estimated six million Americans have AFib, and many of those may not know they have it.
AFib occurs when the upper chambers of the heart experience conflicting electrical signals and beat out of coordination with the heart’s lower chambers resulting in a fast and irregular heart rhythm. AFib can be a precursor to more serious cardiovascular events and stroke.
“People who experience arrhythmias may or may not have symptoms,” said Dr. Joseph Orme, DO, an electrophysiology cardiologist at Intermountain Southwest Cardiology. “Symptoms of atrial fibrillation can include shortness of breath, heart palpitations, lessened exercise capacity, and tiredness. Some people feel like their heart is racing, fluttering, or jumping.”
AFib is a progressive condition that does not have a cure. AFib symptoms may come and go. An atrial fibrillation episode may resolve on its own, or symptoms may be persistent and require treatment. With or without symptoms, an abnormal and rapid heart rate can result in poor blood flow, putting a person at risk for cardiovascular events or stroke.
“The most common risk factor for atrial fibrillation is aging,” said Dr. Orme. “As people age, chambers in the heart can enlarge, stretch and change, just like skin, hair, and other systems change. Approximately as many as 2 out of every 10 people over the age of 80 will experience atrial fibrillation. Controlling the symptoms is important to preserve quality of life and prevent stroke.”
Other common risk factors for AFib include genetics, heart damage, sleep apnea, and obesity.
Dr. Orme indicated people may have a 40% increased risk of experiencing AFib if they had a parent with atrial fibrillation. Advancing age, a previous heart attack, or high blood pressure, can damage heart muscle, leading to AFib.
Research has also consistently shown a correlation between sleep apnea and atrial fibrillation. Seeking treatment for sleep apnea, may lesson symptoms of AFib. Modifiable risk factors for AFib include a heart-healthy diet full of fruits, vegetables, and whole grains, as well as regular physical exercise to maintain a healthy weight.
Recent studies suggest smart watches and other fitness heart-monitoring devices may help detect atrial fibrillation. While an AFib alert from a smart watch may warrant a timely visit with a cardiologist, it should not necessarily necessitate a trip to the emergency department.
“Smart watches and other self-monitoring fitness devices can be good tools to help identify certain issues,” said Dr. Orme. “These devices, however, may not always be accurate. A false positive AFib alert from a smart watch can increase stress, anxiety, and blood pressure – all of which are not good for your heart. If you have any concerns about your heart rhythm, go see your cardiologist.”
“Atrial fibrillation is manageable and has many treatment options,” Dr. Orme said. “To prevent stroke and other types of thrombosis, patients with AFib should consider a blood thinner or anticoagulant medication. Cardiologists use a risk stratification scoring system to help identify patients who will benefit from blood-thinning medications. We are thoughtful and careful of who should be prescribed these medications.”
Treatments also include medication and/or minimally invasive procedures for either a rate-control strategy versus a rhythm-control strategy, based on symptoms. Medications can help keep a heart rate within a normal range or help keep a more normal heart rhythm. Minimally invasive procedures, such as an ablation, are also very efficacious treatment strategies.
“Depending on the symptoms, a cardiologist may try different treatment options to see what works best,” said Dr. Orme. “Treatments and medications are always evolving. For example, the new Watchman procedure is minimally invasive and may be a good option to reduce the risk of stroke in those who may not tolerate oral anticoagulation long-term.”
Working with a cardiologist to reduce stroke risk is most important to maintaining quality of live with AFib. With the right treatment plan, people with atrial fibrillation can live long, healthy, and happy lives.
“An electrophysiologist is an electrician for your heart,” Dr. Orme added. “With the many treatment options currently available for atrial fibrillation, we are here to help people live the healthiest lives possible with AFib.”
This LiVe Well column represents collaboration between healthcare professionals from the medical staffs of our not-for-profit Intermountain Healthcare hospitals and The Spectrum & Daily News.