On average, your heart can beat more than 100,000 times a day and pump 2,000 gallons of blood. It is an amazing machine, but sometimes, the heart doesn’t beat as you would expect. Perhaps, you notice a fluttering sensation or an unexpected acceleration of heartbeats. If this happens, you could have a condition called atrial fibrillation, or AFib.
Shane Rowan, MD, is a cardiac electrophysiologist at Banner Health in Colorado. He explains that AFib is the most common abnormal heart rhythm in the world.
“There are more than 5 million patients in the United States alone that have atrial fibrillation not related to a significant heart valve problem,” Dr. Rowan said. “And, that number is expected to at least double by 2050.”
With AFib being such a common problem, let’s take some time to understand more about it.
What is AFib?
To better understand AFib, it helps to understand the heart and how it works. The heart is a structure made up of four distinct chambers. The upper chambers are called the atria, and the lower chambers are called the ventricles.
Within the right atrium—the upper right chamber—there is a special cluster of cells called the sinoatrial node, or SA node. These cells tell the heart when it needs to contract or beat. The signal starts at the SA node and then travels along to the other chambers to make them contract as they normally would, allowing the proper amount of blood to be pushed out through the body.
With atrial fibrillation, those signals are not organized, which causes the heart to quiver. Because the beats are no longer coordinated, uneven amounts of blood pump out of the heart.
The quivering or fluttering sensation is the most common symptom of AFib, as Dr. Rowan notes. While not all patients experience this, you may not be surprised to hear the symptom that Dr. Rowan says tends to be patients’ biggest complaint.
“They don’t have energy,” Dr. Rowan said. “They just don’t have the ‘get up and go’ that they normally would.”
While the typical symptoms certainly can be concerning, it’s the increased risk of stroke that makes AFib even more worrisome. According to Dr. Rowan, AFib can increase your risk of stroke dramatically, depending on underlying risk factors. Some risk factors for stroke with AFib include:
- Being 65 years or older
- Having diabetes
- Being female
- Having high blood pressure
- Previous heart failure or heart attack
- Previous stroke or near stroke
AFib may be persistent and last more than 7 days. This typically means the heart is no longer able to control its rhythm as it normally should. It can also be intermittent where there are periods of normal rhythm between instances of rapid rhythm.
Who gets AFib?
Dr. Rowan notes there is no one race or culture that gets AFib. Instead, it’s just a very common abnormal heart rhythm, but age does play a role in it.
“Generally, most patients acquire it later in life,” Dr. Rowan said. “There are some congenital heart issues that predispose patients to atrial fibrillation when they're younger, but if you don't have underlying congenital or structural heart disease, it can just come on later in life.”
If you have been diagnosed with AFib, it is very likely to come back, whether persistent or intermittent, according to Dr. Rowan. However, that doesn’t mean you should stop taking care of yourself. Dr. Rowan says to continue to monitor your diet and exercise regularly as much as you can.
“We recommend that patients follow up with their doctors regularly and keep a close eye on their symptoms and, if they're concerned about anything, to contact their primary care doctor or their cardiologist,” Dr. Rowan said.
What treatments are available for AFib?
Dr. Rowan notes there are several different approaches to treating AFib. Some of the treatment options he discusses include:
- Controlling the heart rate and keeping the patient in the abnormal rhythm when persistent AFib is present
- Medication to help manage intermittent AFib symptoms
Other possible treatments include:
- Electrical cardioversion, which sends small shocks to the heart to put it back into a normal rhythm
- Ablation, a minimally invasive procedure where small catheters send out energy to correct the cause of your atrial fibrillation
- Convergent procedure, a combination of a small surgical incision to treat atrial fibrillation from the outside of the heart and the ablation mentioned above
Of course, if your stroke risk is higher with AFib, your doctor will likely prescribe a blood thinner to help reduce that risk. However, blood thinners may not be the best or safest option for all patients. In these cases, the doctor may recommend a catheter-based therapy, such as a left atrial appendage closure. This uses an implantable device approved by the FDA to help keep a patient’s stroke risk low without needing to take blood-thinning medication long term.
If you think you may be experiencing AFib symptoms, we recommend you see your doctor as soon as possible. The doctor will test your heart and heart’s rhythm to find any potential problems. The doctor will likely order an electrocardiogram, or ECG, which monitors your heart’s rhythm.
Other tests the doctor may order include:
- Outpatient/ambulatory heart rhythm monitoring
- Cardiac stress test to check the heart’s blood flow
- Blood tests to check for any underlying diseases, such as diabetes or thyroid problems
- A sleep study if the doctor suspects sleep apnea
To find a doctor that can help, visit: https://www.bannerhealth.com/physician-directory
For information on other heart conditions, check out these resources.
This article has been updated as of July 9, 2020