So You've Got Atrial Fibrillation — What's Next?

Atrial fibrillation is common and treatable

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

Atrial fibrillation (AFib) is the most common cause of irregular heartbeat, affecting nearly 2.7 million Americans. If left untreated, it can significantly increase the risk of stroke and other heart problems. But what does an AFib diagnosis really mean?

What Is Atrial Fibrillation?

AFib is a heart condition that occurs when the top two chambers of the heart (the atria) receive irregular electrical signals. Electrical signals are what trigger the heart muscles to contract. The timing of this is critical. Abnormal signaling can cause irregular heartbeat (arrhythmia) and abnormal blood flow to the rest of the body.

According to the National Heart, Lung, and Blood Institute and the American Heart Association (AHA), untreated AFib can double the risk of heart-related death and quadruple the risk of stroke.

In an interview with dailyRx News, Michael Rothkopf, MD, a specialist in interventional cardiology on the medical staff at Baylor Scott & White Medical Center – Irving, explained that AFib is generally not hereditary.

Instead, it is thought to be caused by persistent high cholesterol or recent heart surgery. AFib is particularly common in older patients.

"Because older people [tend to] have had high blood pressure, coronary disease or other problems with their heart, it often predisposes them to atrial fibrillation," Dr. Rothkopf said.

What Are the Symptoms?

The most common symptoms of AFib are an irregular heartbeat or an irregular pulse. This may feel like a fluttering in the chest, a racing heartbeat or a slowed heartbeat.

Other symptoms are typically related to the heart not pumping effectively, such as fatigue, shortness of breath, confusion, dizziness, weakness and sweating.

"A lot of times you do feel it because sometimes [the heartbeat] is very rapid," Dr. Rothkopf said. "Other times it is slow and it feels funny to you because it is very slow and others times just because it's irregular. But many people who have atrial fibrillation are totally unaware of it."

Is AFib Dangerous?

According to the AHA, AFib can damage the heart muscle over time. If left untreated, this can lead to heart disease.

Because blood is no longer flowing smoothly throughout the heart and body, blot clots or stroke can also occur.

How Does AFib Affect Daily Life?

With treatment, patients can usually return to their normal lives. However, some lifestyle changes may be recommended. These include following a healthy diet, exercising, cutting back on salt to reduce blood pressure, quitting smoking and reducing stress.

"As a general rule for people who are diagnosed with atrial fibrillation and have moderate activity — let's say not competitive sports or a lot of athletics — you don't have to do much as far as lifestyle," Dr. Rothkopf said. "You can work out, you can walk on your treadmill, you can do yoga, you can play golf, you can ski. But you do have to take your medication — that's important."

For patients on blood thinners, contact sports should be avoided because these medications can affect the body's ability to heal.

What Are the Treatments?

According to the AHA, the following are the typical treatment goals after an AFib diagnosis:

  • Restoring the normal rhythm of the heart
  • Reducing heart rate
  • Preventing blood clots
  • Preventing heart failure

These goals can be achieved through medication, nonsurgical procedures and surgery.

Medications are typically prescribed to control the rate or rhythm of the heart. This can reduce a patient's symptoms and improve blood flow. These medications include beta-blockers, calcium channel blockers, sodium channel blockers and potassium channel blockers. Patients sometimes need to be monitored in a hospital when these treatments are started. Blood-thinning medications are also often prescribed to prevent blood clots, which can result from poor blood flow and lead to stroke.

The rhythm of the heart can sometimes be reset nonsurgically by a minor shock to the chest, called electrical cardioversion. Another nonsurgical option is cardiac ablation of the area that is causing the unusual electrical signals. This is performed by inserting a tiny device into the heart and carefully destroying the area by burning or freezing it.

Pacemakers can be installed surgically to control heart rhythm, while a more complex procedure — called a maze surgery — creates a network of scar tissue which interrupts the electrical signals to restore a normal rhythm.

According to Dr. Rothkopf, the best treatment option depends on the individual patient.

The longer AFib persists, however, the more difficult it is to cure. AFib patients should set up a treatment plan with their doctor.

Review Date: 
September 3, 2015