Your heart beats more than 100,000 times a day, on average. But sometimes, those heartbeats can be erratic. You may find that your smartwatch picks up signs of an abnormal heart rate. You might notice a fluttering sensation or your heart beats faster. You could feel more easily fatigued when you have these symptoms. Signs like these could point to a condition called atrial fibrillation (AFib or AF).
Shane Rowan, MD, a cardiac electrophysiologist at Banner Health in Colorado, said that “AFib is the most common irregular heart rhythm in the world. In the U.S. more than 5 million people have atrial fibrillation not related to a significant heart valve problem.” And the Centers for Disease Control and Prevention (CDC) estimates that 12.1 million people in the U.S. will have AFib by the year 2030. Here, Dr. Rowan answers some questions about the condition.
What is AFib?
To understand AFib, it helps to understand how the heart muscle works. The heart is made up of four chambers. There are two upper chambers called atria and two lower chambers called ventricles. The upper right chamber of the heart contains a cluster of cells called the sinoatrial node, or SA node. Every time your heart beats, a signal starts at the SA node. It then travels to the other chambers to make them contract and push blood out to the body.
With atrial fibrillation, those signals go “haywire.” The heart may quiver, and varying amounts of blood pump out of the heart. “The quivering or fluttering sensation is the most common symptom of AFib,” Dr. Rowan said. “People also often notice a lack of energy. They don’t have the ‘get up and go’ that they normally would.”
AFib can be intermittent, occurring before and after periods of normal heart rhythm. It may also be persistent and last more than seven days. When it’s persistent, the heart can no longer control its rhythm properly.
AFib also increases your risk of blood clots and stroke. You’re at higher risk of stroke with AFib if you:
- Are 65 years old or older
- Have diabetes
- Are female
- Have high blood pressure
- Have or have had heart disease (including heart failure, heart attack, stroke or near stroke)
“Stroke is the most serious consequence of atrial fibrillation. It can be devastating. So, it’s crucial to diagnose and treat atrial fibrillation,” Dr. Rowan said.
What are the risk factors for AFib?
Everyone is at risk for atrial fibrillation. It is the most common heart rhythm abnormality, and it is more common as we age. “Some people are born with heart conditions that make them more likely to develop AFib when they are young. But generally, most people develop it later in life,” Dr. Rowan said. Diabetes, high blood pressure, sleep apnea and excessive alcohol use increase your risk of developing atrial fibrillation.
Maintaining a healthy body weight, getting regular physical activity and avoiding alcohol use can reduce your risk of AFib.
Many people think drinking coffee can cause AFib. “However, there is no association between coffee use and atrial fibrillation,” Dr. Rowan said.
How is AFib diagnosed?
If you have symptoms of AFib, your doctor will likely order an electrocardiogram, or ECG, to test your heart’s rhythm. Additional tests may include:
- Outpatient or ambulatory heart rhythm monitoring with a Holter monitor
- 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 to check for sleep apnea
Once you are diagnosed with AFib, it is likely to come back. But Dr. Rowan says to continue to monitor your diet and exercise regularly.
What treatments are available for AFib?
“Treatment for atrial fibrillation is a complex process,” Dr. Rowan said. After you’re diagnosed, your doctor may order additional tests to see what’s causing your AFib and to guide treatment.
Treatment options include:
- Daily medications to slow the heart rate, for people with persistent AFib
- Medication to help manage intermittent AFib symptoms
- Electrical cardioversion, which sends small shocks to the heart to put it back into a normal rhythm
- Catheter ablation, a minimally invasive procedure that corrects the abnormal electrical signals inside the heart
- Convergent procedure, which combines a small surgical procedure with ablation
- Heart surgery
“We recommend that you follow up with your doctor regularly and keep a close eye on your symptoms. Contact your primary care doctor or cardiologist if you have any concerns,” Dr. Rowan said.
Since AFib increases stroke risk, your doctor may prescribe a blood thinner to help reduce that risk. However, the side effects and other concerns that come with blood thinners may also mean they aren’t always the best option. In that case, your doctor may recommend an implantable device that can help keep your stroke risk low without the need for long-term blood-thinning medication.
The bottom line
Atrial fibrillation is a common heart rhythm disorder that causes your heart to beat irregularly. If you have symptoms of atrial fibrillation, it’s important to seek treatment since AFib leads to an increased risk of stroke. If you would like to connect with a physician to talk about any heart concerns, Banner Health can help.