The heart is a crucial organ in our bodies, and a strong, healthy heart beats in a steady rhythm. If it doesn’t, this is called an arrhythmia — when the heart beats too quickly, too slowly or in an irregular pattern.
The most common type of arrhythmia is atrial fibrillation, or AFib — a fast and irregular heart rhythm where the upper and lower chambers of the heart are not coordinated — which affects at least 2.7 million Americans. If untreated, AFib can lead to blood clots, stroke and heart failure.
Rush electrophysiologist Jeremiah Wasserlauf, MD, MS, who specializes in treating heart rhythm disorders, shares five facts about AFib and tips to prevent or help manage the condition.
1. Some people with AFib don’t recognize they have symptoms.
Some people with AFib may not recognize they are experiencing symptoms, which can make it difficult to know they have it. And research shows that up to 30% of AFib episodes cause no symptoms at all.
“Everyone is different,” Wasserlauf says. “Some people have obvious symptoms of AFib and other people may experience very little. There are some people who realize, after treatment to restore normal rhythm, that they actually feel better and had been limiting their activity because of symptoms of AFib without realizing it.”
Those who show signs of AFib may experience the following:
- Irregular heartbeat
- Heart palpitations (rapid, fluttering or pounding)
- Extreme fatigue
- Shortness of breath
- Chest pain
Whether or not you are symptomatic, Wasserlauf stresses the importance of keeping up with annual visits to your primary care provider, and to be cared for by a specialist if you've been diagnosed.
2. You can help prevent AFib by managing risk factors.
The risk of AFib increases with age — the greatest risk factor for the condition. Although aging is unavoidable, other heart-related risk factors can be prevented or managed for a better outcome. High blood pressure, for example, accounts for about 1 in 5 cases of AFib, according to the Centers for Disease Control and Prevention.
“Some risk factors for AFib are hereditary, some are acquired, and often both types of risk are contributing,” Wasserlauf says. “This means that you may have a family history that predisposes you to AFib or individual risk factors that cause you to develop the condition. But some people even in the best health will still be at risk due to age alone.”
Other risk factors of AFib include the following:
- Chronic kidney disease
- Heart disease
- Heart failure
- Moderate to heavy alcohol use
To help manage your risk factors, Wasserlauf suggests maintaining a healthy weight, avoiding excess consumption of alcohol, and working with your doctors to keep any chronic medical problems well controlled.
3. AFib is related to strokes.
In AFib, a chaotic rhythm may cause blood to pool in the heart's upper chambers and form clots. If a blood clot forms, it could travel to the brain where it could block the flow of blood and lead to a stroke.
AFib causes about 1 in 7 strokes, according to the CDC. The risk of AFib-related stroke increases with age, Wasserlauf says, and depends on your other risk factors.
“We find that strokes caused by AFib tend to be more severe than strokes from other causes,” he adds. “But fortunately, these strokes are preventable in most people, so it’s important to work closely with your doctor to make sure you are on the right treatments to be protected.”
4. Treatment options continue to evolve.
Over the past decade, treatment options for AFib have evolved significantly, becoming safer and more effective.“The treatment options we have today allow people with AFib to live normal lives and not be limited or restricted by the condition,” Wasserlauf says.
Catheter ablation is a minimally invasive outpatient procedure that uses hot or cold energy to treat areas of the heart responsible for atrial fibrillation and ultimately restore a normal heart rhythm. In the best candidates, this can reduce a person’s time in AFib by over 98%. Medications, such as blood thinners (to prevent strokes in AFib), have also become more effective and manageable, he says, as they no longer require dietary restrictions or frequent monitoring and dose adjustments.
But some people living with AFib, particularly those who have a history of internal bleeding or frequent falls, may be unable to take blood thinners. A WATCHMAN device is an alternative option to prevent stroke using a minimally invasive, one-time procedure to close off the left atrial appendage — a small pouch connected to the upper left chamber of the heart where clots form.
“The treatment options for AFib continue to progress forward, and as a provider, it’s rewarding to see how much better people can feel,” Wasserlauf says.
5. Maintaining a healthy lifestyle is key.
Lifestyle modifications can help prevent conditions that complicate AFib, such as obesity, diabetes and heart disease, and can improve the response to treatments for AFib.
Here are a few lifestyle changes to help manage your AFib:
- Exercise regularly. “Exercise is healthy for people with AFib,” Wasserlauf says. “And if people have worsening symptoms due to exercise, such as a racing heart, that’s where we step in to help control their AFib better and enable them to exercise without restrictions.” He suggests engaging in 150 minutes of moderate exercise per week, such as jogging, biking or walking.
- Eat healthy and maintain a healthy weight. A diet designed for people with heart disease can be helpful for people with AFib. The American Heart Association suggests focusing your diet on fruits and vegetables and include foods that are low in sodium.
- Monitor your alcohol intake. People who drink heavily, or binge drink, are more likely to experience an AFib episode. Wasserlauf recommends sticking to one alcoholic beverage per day or less.
- Manage other health conditions, such as sleep apnea, high blood pressure, diabetes, among others.
- Quit smoking. Smoking has toxic effects on all aspects of the heart including the rhythm. Talk to your doctor about ways to quit smoking.
- Manage stress levels. “An increased level of stress on the body can worsen AFib symptoms,” Wasserlauf says. “Regular yoga or mindfulness practice can help reduce and manage your stress levels, and has been shown to improve AFib.”