What is Atrial Fibrillation?
Atrial fibrillation is the most common type of heart arrhythmia (irregular heartbeat) characterised by rapid and irregular beating of the atria. It causes an interruption in the normal flow of blood. This interruption means the conditions puts you at risk of blood clots and stroke.
Between 2.7 and 6.1 million U.S. people have atrial fibrillation (AFib or AF).
With AFib, the two upper chambers of your heart (atria) are affected. This disrupts blood flow to the ventricles or the lower chambers, and then throughout the rest of your body.
If left untreated, AFib can be deadly.
Atrial fibrillation may be temporary, may come and go, or may be permanent. It’s also most common in adults over the age of 65. But with proper medical care, you can live a normal, active life.
Symptoms of Atrial Fibrillation
You might not experience any symptoms if you have atrial fibrillation.
Those who do experience symptoms may notice:
- heart palpitations (feeling like your heart is skipping a beat, beating too fast or hard, or fluttering)
- chest pain
- shortness of breath
- intolerance to exercise
These symptoms can come and go based on the severity of your condition.
For example, paroxysmal AFib is a type of atrial fibrillation that resolves on its own without medical intervention. But you may need to take medication to prevent future episodes and potential complications.
Overall, you might experience symptoms of AFib for several minutes or hours at a time. Symptoms that continue over several days could indicate chronic AFib.
Treatment of Atrial Fibrillation
You might not need treatment if you don’t have symptoms, if you don’t have other heart problems, or if the atrial fibrillation stops on its own.
If you do require treatment, your doctor may recommend the following types of medications:
- beta-blockers to decrease your heart rate
- calcium channel blockers to relax arterial muscles and decrease overall heart rate
- sodium or potassium channel blockers to control heart rhythm
- blood thinners to prevent blood clots from forming
- digitalis glycosides to strengthen your heart contractions
Generally, the purpose of taking medications for AFib is to normalize your heart rate and promote better heart function overall.
These medicines can also prevent possible blood clotsin the future, as well as related complications such as heart attack and stroke.
Causes of Atrial Fibrillation
The heart contains four chambers: two atria and two ventricles.
Atrial fibrillation happens when these chambers don’t work together as they should because of faulty electrical signaling.
Normally, the atria and ventricles contract at the same speed. In atrial fibrillation, the atria and ventricles are out of sync because the atria contract very quickly and irregularly.
The cause of atrial fibrillation isn’t always known. Conditions that can cause damage to the heart and lead to atrial fibrillation include:
- high blood pressure
- congestive heart failure
- coronary artery disease
- heart valve disease
- hypertrophic cardiomyopathy, in which the heart muscle becomes thick
- heart surgery
- congenital heart defects, meaning heart defects you’re born with
- an overactive thyroid gland
- pericarditis, which is inflammation of the sac-like covering of the heart
- taking certain medications
- binge drinking
- thyroid disease
An overall healthy lifestyle may decrease your risk of AFib. But not all causes are preventable.
Risk factors for Atrial Fibrillation
While the exact cause of AFib isn’t always known, there are some factors that may put you at a higher risk for this condition. Some of these may be prevented, while others are genetic.
Talk to your doctor about the following risk factors:
- increased age (the older you are, the higher your risk)
- being white
- being male
- history of heart surgery
- thyroid conditions
- metabolic syndrome
- lung disease
- drinking alcohol, especially binge drinking
- sleep apnea
- a family history of atrial fibrillation
- heart disease
- structural heart defects
- congenital heart defects
- history of heart attacks
- high-dose steroid therapy
Complications of Atrial Fibrillation
Regular medical treatment and checkups with your doctor can help you avoid complications. But if it’s left untreated, atrial fibrillation can be serious and even deadly.
Serious complications include heart failure and stroke. Medications and lifestyle habits can both help prevent these in people with AFib.
A stroke happens as a result of a blood clot in the brain. This deprives your brain of oxygen, which can lead to permanent damage. Strokes can also be fatal.
Heart failure occurs when your heart can no longer function properly. AFib can wear down the heart muscle, as the ventricles in the lower chambers attempt to work harder to make up for the lack of blood flow in the upper chambers.
In people with AFib, heart failure develops over time — it’s not a sudden occurrence like a heart attack or stroke might be.
Following your treatment plan can reduce your overall chances of complications due to AFib.
Take all your medications as prescribed by your doctor.
Diagnosis of Atrial Fibrillation
There are several different tests that can be done to get a better idea of what’s going on with your heart function.
Your doctor may use one or more of the following tests to diagnose atrial fibrillation:
- a physical exam to check your pulse, blood pressure, and lungs
- an electrocardiogram (EKG), a test that records the electrical impulses of your heart for a few seconds
If atrial fibrillation doesn’t occur during the EKG, your doctor may have you wear a portable EKG monitor or try another type of test.
These tests include:
- Holter monitor, a small portable device you wear for 24 to 48 hours to monitor your heart.
- event monitor, a device that records your heart only at certain times or when you’re having symptoms of AFib
- echocardiogram, a noninvasive test that uses sound waves to produce a moving image of your heart.
- transesophageal echocardiogram, an invasive version of an echocardiogram that’s performed by placing a probe in the esophagus
- stress test, which monitors your heart during exercise
- chest X-ray to view your heart and lungs
- blood tests to check for thyroid and metabolic conditions
Atrial Fibrillation Surgery
For chronic or severe AFib, surgery may be a recommended option.
There are different types of surgeries that target the heart muscle in an effort to help it pump blood more efficiently. Surgery may also help prevent heart damage.
Types of surgeries that may be used to treat AFib include:
In this procedure, a brief electrical shock resets the rhythm of your heart contractions.
In catheter ablation, a catheter delivers radio waves to the heart to destroy the abnormal tissue that sends out irregular impulses.
Atrioventricular (AV) Node Ablation
Radio waves destroy the AV node, which connects the atria and ventricles in this procedure. Then the atria can no longer send signals to the ventricles.
A pacemaker is inserted to maintain a regular rhythm.
This is an invasive surgery that can be either open-heart or through small incisions in the chest, during which the surgeon makes small cuts or burns in the heart’s atria to create a “maze” of scars that will prevent abnormal electrical impulses from reaching other areas of the heart.
This surgery is only used in cases when other treatments were unsuccessful.
Your doctor might also recommend other procedures to treat underlying health conditions, such as thyroid or heart diseases, which might be causing your AFib.
Surgery is one treatment method for AFib. Still, medications and lifestyle changes are recommended as first lines of treatment.
Prevention of Atrial Fibrillation
Most cases of atrial fibrillation can be managed or treated. But atrial fibrillation tends to reoccur and get worse over time.
You can reduce your risk of atrial fibrillation by doing the following:
- eat a diet that’s rich in fresh fruits and vegetables and low in saturated and trans fat
- exercise regularly
- maintain a healthy weight
- avoid smoking
- avoid drinking alcohol or only drink small amounts of alcohol occasionally
- follow your doctor’s advice for treating any underlying health conditions that you have
The most common complications of AFib are strokes and heart failure.
If you have AFib and aren’t taking proper medication, you are five times more likely to have a stroke than people who don’t have AFib.
Diet for Atrial Fibrillation
While there’s no set diet for atrial fibrillation, dietary concerns for AFib focus on heart-healthy foods instead.
A diet for AFib will likely include more plant-based foods, such as oats, fruits, and vegetables.
Fish is also a good source of protein, and its omega-3 fatty acid content makes it especially good for the heart.
There are foods and substances that can make AFib worse. These include:
- alcohol (especially when binge drinking)
- caffeine — coffee, soda, tea, and other sources can make your heart work even harder
- grapefruit, which can interfere with AFib medications
- gluten, which can increase inflammation if you have an allergy or sensitivity
- salt and saturated fats
- vitamin K-rich foods, such as darky leafy greens, as these can interfere with blood-clotting meds
An AFib diet is much like any heart-healthy diet. It focuses on nutrient-rich foods, while avoiding irritating substances and low-density foods.
Natural Treatments for Atrial Fibrillation
Aside from dietary recommendations, your doctor may also suggest certain supplements if you’re low in key nutrients vital to heart health.
Talk to your doctor before taking any additional supplements because these could have side effects or interact with medications.
Some of the supplements used for AFib include:
- fish oil
- coenzyme Q10
- wenxin keli
- hawthorn berry
Other natural treatments for AFib include healthy lifestyle habits, like exercise and stress reduction. Exercise is important for your heart health, but you’ll want to take it slow, especially if you’re new to working out.
High-intensity exercises, like running, might be too much for people with AFib. But moderate to lower-intensity activities, like walking, swimming, and cycling, can still burn calories, strengthen your heart, and alleviate stress.
Since stress can also affect your heart health, it’s crucial to maintain a healthy state of mind. Deep breathing exercises can alleviate everyday stresses, while a yoga class can help you achieve a deeper meditative state (with the added bonus of muscle and flexibility).
Even making the time to enjoy a favorite hobby can help you achieve more relaxation and improved heart health.
Natural treatments may help AFib when used together with conventional medical treatments.
More research is needed to determine whether alternative treatments can help alone, so stick to your medical plan.
Atrial Fibrillation Guidelines
The official guidelines for AFib, according to the American Heart Association, outline the treatment options based on your existing condition and medical history.
Your doctor will likely use these when recommending a treatment plan.
In general, a combination of lifestyle habits and medications can help you prevent heart failure and stroke.
Your doctor will also classify your AFib to determine if it’s acute (short-term) or chronic (long-term). Age, gender, and overall health will also determine individual risk factors.
Overall, your treatment will focus on:
- controlling heart rate and rhythm
- assessing stroke risk
- assessing risk of bleeding
Atrial Fibrillation vs. Flutter
Sometimes AFib can be confused with flutters. The symptoms are similar, including rapid heart rate and irregular pulse.
While both affect the same heart chambers and result in arrhythmias, these are two different conditions.
Atrial flutters happen when electrical signals in the heart quicken. The symptoms and risk factors are similar with AFib.