Chances are, either you or someone in your life will be directly affected by atrial fibrillation. Between 2.7 and 6.1 million people in the United States have this condition – this number will only increase as our population ages. Despite being so common, it is generally undertreated, underdiagnosed, and there is a shortage of quality patient education resources.
1) What exactly is atrial fibrillation?
Atrial fibrillation (“AFib”) is a type of arrhythmia (abnormal heart rhythm) that affects the top chambers of the heart (the atria). AFib produces a type of heartbeat that is irregular or fast. Your heart beats without any order, which makes it difficult to pump blood in a normal way. This condition increases a person’s risk of stroke, heart failure, and other heart problems.
2) What symptoms are associated with it?
People present in a multitude of ways. Some patients feel no symptoms at all and may not even know that they have it. Other patients are exquisitely sensitive to this condition and can tell the moment an episode begins. Symptoms can include heart palpitations, feeling tired or a lack of energy, a pulse that is faster than normal or irregular, shortness of breath, trouble with everyday activities or exercise, chest discomfort or pain, dizziness, lightheadedness, or fainting.
3) Are there risk factors related to developing it?
Risk factors associated with AFib are high blood pressure, heart failure, tobacco use, age, diabetes, obesity, a family history of this condition, sleep apnea, and (unexpectedly) exercising often and hard.
4) One of my parents had atrial fibrillation, does this mean that I will develop it?
Atrial fibrillation is heritable. Individuals having a first-degree relative with Afib have approximately a 40% increased risk for developing the condition; however, that does not mean that you cannot do things to help reduce your risk of developing it.
5) What can I do today to help reduce my chances of developing this arrhythmia?
Maintain a healthy lifestyle and weight. Avoid tobacco usage, and it is essential to diagnose any sleep apnea. Managing these medical conditions can have a significant effect on your risk of developing this condition.
6) Describe the relationship between atrial fibrillation and your stroke risk.
Atrial fibrillation is thought to be the cause of approximately 1-in-5 strokes that occur annually. The good news is that proper management and the use of blood thinners can significantly mitigate this risk.
7) What is the natural course of this condition?
“Atrial Fibrillation begets atrial fibrillation.” When a patient has an episode of Afib, there are microscopic changes and fibrosis that occurs in the top chambers of the heart (atria). These changes can make Afib episodes more frequent and severe with time. This condition does not go away on its own. Other medical conditions such as obesity, sleep apnea, high blood pressure can accelerate this progression. If left unmanaged, patients may even go into “permanent atrial fibrillation,” where they remain in this arrhythmia indefinitely.
8) What treatment options are there for this condition?
Patients should be evaluated by an Electrophysiologist, which is a Cardiologist that specializes in the heart’s electrical system. Appropriate treatment includes any combination of aggressive risk factor modification, medication, and ablation. Cardiac ablation is an outpatient procedure that targets known electrical triggers for this arrhythmia and uses either cold or heat energy to eliminate them. A good treatment strategy should be tailored to the individual patient – there is no “one size fits all.”
9) What does a cardiac ablation entail?
It is an outpatient procedure where the electrical triggers for this arrhythmia are targeted and systematically eliminated. Access into the heart is gained through the femoral vein in the groin, and advanced mapping software is used to create a 3-D replica of your heart. This map helps the operator find these electrical targets. Patients usually leave the hospital the same day, and recovery is typically brief (hours).
10) Where can I get more information about atrial fibrillation?
Finding a quality Electrophysiologist is an essential step in properly diagnosing and managing this condition. Great online patient resources are www.upbeat.org (Heart Rhythm Society) and www.heart.org (American Heart Association).
To schedule a visit, please call or text: (786) 349-3129 or visit www.MyCardiologist.com
Calkins, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. Oct 2017;10:e281-391.
Yasser Rodriguez, M.D., M.B.A., FACC, is a cardiac electrophysiologist in the South Florida community. In addition to managing general adult cardiac conditions, he specializes in arrhythmias, pacemakers, defibrillators, and advanced ablations. He has authored several peer-reviewed articles and book chapters, mainly focusing on new approaches to cardiac procedures.