Once you find the right treatment, it’s possible to have a normal life with AFib.
Atrial Fibrillation, or AFib, is the most common heart arrhythmia and can cause blood clots, heart attack, and stroke. It affects more than 2.7 million Americans, according to the American Heart Association (AHA), and about 10 percent of people over age 80 are afflicted with it.
If your heart beats irregularly or too fast, you may have AFib. Some people go symptom-free for years, only to be diagnosed at their annual checkup. For others, the AFib symptoms are what bring them to the doctor’s office. Common symptoms include dizziness, sweating, and chest pain and pressure, according to Dr. Dan Roden, cardiologist and volunteer AHA spokesperson.
“Some patients have an awareness of their heart beating irregularly or rapidly,” he said. “They have an uncomfortable feeling in their chest, and they know their heart is not beating the way it should.”
Other symptoms include shortness of breath, tiring easily when exercising, and fainting.
“Their exercise is limited,” said Dr. Barry Jacobs, Director of Behavioral Sciences for Crozer-Keystone Family Medical Residence Program and AHA spokesperson. “AFib is sometimes difficult to diagnose because when they exert themselves, their heart pumps up to 150 to 180 [beats per minute.] It’s not always consistent.”
There are different types of the disorder. Paroxysmal AFib is intermittent, where fibrillation comes and goes. It can transition to Persistent AFib, where a patient is in AFib longer than seven days. Long-standing AFib lasts longer than 12 months.
“A patient may say his heart is beating funny and it feels irregular,” Roden said. “He may say it feels like it’s bouncing around in his chest. The doctor might feel an irregular heartbeat. The problem is when [AFib] starts, it tends to come and go. The patient my say he had symptoms but not in a while. This is when you record the heart rhythm. The longer you look, the more likely you’ll find it.”
A normal EKG only lasts 12 seconds, Roden said. If symptoms are inconsistent, a patient may have to wear a Holter Monitor — a battery operated portable device that measures and records his heart’s activity continuously for 24 to 48 hours.
More long-term devices can record activity for a few weeks. There are now even Smartwatches that can monitor AFib, and cell phone-enabled heart monitoring is on the horizon. It consists of a device attached to a cell phone, and when a patient feels symptoms, he touches patches on the cell phone with his finger, recording an abnormal rhythm.
Treatments
Once AFib is diagnosed, it’s important to find the right treatment. There are three kinds of therapies:
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Blood thinner is used to decrease the risk of blood clots and stroke, and/or other medications to work on the heart’s electrical system.
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Cardioversion, which is a shock to the chest while the patient is sedated, is performed in a hospital or clinic. The shock briefly stops the heart to reset its rhythm. In most cases, patients wake up quickly and don’t remember the shock.
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Ablation is used when drugs and cardioversion are ineffective. This is when a catheter is inserted into the heart, making AFib less likely to occur.
In extreme cases, when nothing else works, a pacemaker is inserted, Roden said.
Prevention
There is no answer to preventing AFib, but as with other heart diseases, it helps to lose weight. Losing weight improves other things that travel with AFib, Rosen said, such as diabetes and sleep apnea.
“Fat is not an inert tissue,” he said. “It’s proinflammatory. Fat around the heart provokes AFib.”
Living with AFib
As with other heart issues, AFib can cause anxiety and depression, Jacobs said.
“With AFib, a person can feel his heart beating faster, and he becomes sensitive to his own pulse,” he said. “It can raise anxiety, and he becomes hyper-focused on that. He can spend the whole day taking his pulse, detracting from [enjoying life.] It can feel like a ticking time bomb.”
The key is to arm yourself with information, Jacobs said. It’s a good rule of thumb to remember that the more a patient knows, the more he can help himself feel in control.
“You have to imagine life as a stage with a spotlight,” Jacobs said. “Do you want AFib in the center? Or do you want to move it off to the side and put friends, family, hobbies, and job centerstage?”
For AFib support, visit My AFib Experience, developed by the AHA.
