By Tessa London-Bounds, M.D.
University of Kentucky
A racing or irregular heartbeat can be unsettling, but for millions of Americans, it can also be a sign of a common heart rhythm disorder called atrial fibrillation, or Afib.
AFib occurs when the heart’s upper chambers, called the atria, beat irregularly and out of sync with the heart’s lower chambers. It is the most common type of irregular heart rhythm. If left unmanaged, AFib can cause strokes, early-onset dementia, blood clots in the heart, heart failure and, ultimately, early death.
AFib is commonly seen in adults over the age of 60, but for many, symptoms go unnoticed or thought to be normal signs of aging. By spreading awareness of what AFib is and how to treat it, this population can make sure they are living life to the fullest.
What causes AFib?
AFib can develop when changes to the heart or its electrical system disrupt the heart’s normal rhythm. In some cases, the cause is unknown.
Risk factors and conditions associated with AFib include:
• High blood pressure
• Coronary artery disease
• Heart valve problems
• Heart failure
• Diabetes
• Thyroid disease
• Sleep apnea
• Obesity
Increasing age, smoking, moderate to heavy alcohol use and a family history of AFib also can increase risk.
Certain medical situations including illness or heart surgery, also can trigger Afib.
What does AFib feel like?
Symptoms can vary from person to person. Some people experience noticeable symptoms, while others have no symptoms and learn they have AFib during a routine examination or testing for another condition.
Common symptoms include:
• A rapid, irregular, pounding or fluttering heartbeat
• Shortness of breath
• Fatigue or weakness
• Dizziness or lightheadedness
• Reduced ability to exercise
• Chest discomfort or pressure
Because AFib can occur without symptoms, regular health care visits can be important for identifying the condition and addressing associated risk factors.
Why does AFib matter if I don’t feel symptoms?
One of the primary concerns with AFib is stroke. When the heart beats irregularly, blood can pool in the atria and form a clot. If a clot travels to the brain, it can cause a stroke. AFib is associated with an approximately fivefold increased risk of ischemic stroke.
How is AFib treated?
Treatment depends on a person’s symptoms, stroke risk, overall health and the characteristics of their Afib.
Medications may be used to slow the heart rate, control its rhythm or reduce the risk of blood clots and stroke. Blood-thinning medications, also called anticoagulants, may be recommended for people who have an elevated stroke risk.
For some patients, specific procedures may be appropriate. Electrical cardioversion uses a controlled electrical shock to restore a regular heart rhythm. Catheter ablation creates small areas of scar tissue that block abnormal electrical signals responsible for Afib.
UK HealthCare now offers a hybrid AFib procedure primarily for patients with long standing or persistent AFib. This condition can be harder to treat with standard approaches alone.
The hybrid treatment option combines a minimally invasive surgical ablation with electrophysiologist ablation and mapping to ensure the highest chances of getting patients suffering from long-standing persistent AFib in a normal sinus rhythm. It is a true collaboration between cardiothoracic surgery and electrophysiology to ensure patients get the best long-term care available.
Lifestyle changes also can be part of AFib management. Regular physical activity, maintaining a healthy weight, managing blood pressure and cholesterol, not smoking and limiting alcohol can help reduce risk factors and support heart health.
If you experience symptoms of AFib, talk with your health care provider about evaluation. Chest pain or pressure is a medical emergency and may indicate a heart attack. Call 911 immediately.
Tessa London-Bounds, M.D., is a cardiothoracic surgeon at Gill Heart & Vascular Institute at the University of Kentucky.