Atrial fibrillation (commonly called AFib or AF) is an arrhythmia, which means the heart beats in an irregular way, either too fast or too slow.
In a healthy heart, an electrical pulse starts in a group of cells, then travels down the heart, first to the two upper chambers (the atria) and then to the lower chambers (the ventricles). With AFib, that electrical signal goes haywire, causing the atria to expand and contract irregularly.
In this case, the electrical signals fire off too fast for the atria contract and squeeze all the blood down to the ventricles. This causes blood to be left behind and pool in the atria. Whenever blood pools, it has a risk of clotting (red blood cells sticking together). If a blood clot forms in the atria and then leaves the heart, there’s a risk of the clot blocking blood flow to the brain—that’s a stroke.
Even though at least 2.7 million Americans are living with AFib, many of them don’t even know they have it because it often doesn’t cause symptoms. Untreated AFib means double the risk of deaths related to the heart, and a five times greater risk for stroke.
September is Atrial Fibrillation Awareness Month. Awareness is important in order to understand this condition, because the people do not know they have AFib are not getting the treatment they need.
While some people with AFib don’t have symptoms and don’t even know they have the condition, others may experience one or more of these symptoms:
- Rapid and/or irregular heartbeat
- Heart palpitations (fluttering or pounding feeling)
- Extreme of extreme fatigue
- Fatigue when exercising
- Faint feeling
- Shortness of breath
- Chest pain or pressure (seek emergency medical assistance for chest pain)
AFib Causes and Risk Factors
- Advanced age (over age 60)
- High blood pressure
- Prior heart attacks or other heart conditions (such as heart failure or heart valve disease)
- Heart conditions you were born with
- Previous heart surgery
- Sleep apnea
- Thyroid disease (hyperthyroidism)
- Heavy alcohol use
- Chronic kidney or chronic lung disease
- Serious illness or infection
- Stress due to surgery or other illness, such as pneumonia
- Viral infections
- Family history
AFib can be discovered by a doctor. This includes your general healthcare provider, but also a specialist such as a cardiologist. This can happen when the doctor checks your heart by taking your pulse to feel your heartbeat or listens to your heart with a stethoscope.
The doctor will also listen to your lungs and check for signs of any heart valve or muscle problems. Your medical history can also reveal to your doctor if you have any related signs or conditions that cause AFib, such as hyperthyroidism (an overactive thyroid).
There are also a number of tests your doctor may order to diagnose the condition. These include:
- Electrocardiogram (ECG or EKG).This is the main test to diagnose AFib. It uses small sensors attached to the chest and arms to record electrical signals as they travel through the heart. It takes only a minute or two, and it is painless.
- A Holter monitor. This is a small (size of a phone) device that records your heart activity like an EKG. It has small electrodes attached to your skin and you carry around the device with you for 24 to 48 hours.
- Event monitor. This is an EKG to carry with you for a few weeks to a few months. It can record anything unusual with your heart, and you also push a button when you feel a fast heart rate, and that information is recorded so your doctor can check your heart rhythm when you have your symptoms.
- Stress test. This test is done during walking or exercising while hooked up to an EKG. It tests heart rate and blood pressure when your heart is put under stress to see how the heart responds to working hard and beating fast.
- Blood tests. Testing your blood can help the doctor to see if there are any other things that could contribute to AFib, such as thyroid or kidney problems, infection or signs of a heart attack.
The seriousness of the AFib, how long you’ve had it and any other conditions you have will determine the best treatment options for you.
There are different types of medications that can help with AFib. These include:
- Beta blocker. Slows the heart rate and lowers the blood pressure.
- Calcium channel blockers. Relaxes the blood vessels.
- Antiarrhythmic. Helps control irregular heartbeat.
- Blood thinner. Thins the blood to prevent blood clots or help dissolve blood clots that already exist.
If medications don’t work, or your condition is serious for other reasons, there are several surgeries for AFib:
- Electrical cardioversion. A painless procedure to shock the heart and get it to a normal beat.
- Catheter ablation. Destroying the cells that cause abnormal heart rhythm with heat or cold.
- Pacemaker. An electronic device placed in the chest to regulate the heartbeat.
- Maze procedure. A type of open-heart surgery to stop AFib by preventing abnormal electrical patterns.
Help Prevent AFib with Lifestyle
Even though white people are more likely than black people to have AFib, at least one study shows that African Americans have double the risk of heart disease than Caucasians. While the researchers say there needs to be more studies as to why this is true, a focus on prevention and treatment of AFib are key.
Here are some lifestyle things you can do to help prevent AFib as well as other health problems:
- Get high blood pressure under control.
- Eat a diet healthy for the heart.
- Do regular physical activity.
- Don’t smoke.
- Don’t consume too much alcohol or caffeine.
- Get to and maintain a healthy weight.
- Control cholesterol.
- Lower stress and anxiety.
If you’re worried about your heart, please be sure to schedule an appointment with your Primary Care Provider or a specialty provider.