A normal heart rate sounds and feels like a steady rhythm. When you have atrial fibrillation, or afib, your heartbeat is uneven or chaotic: It can race quickly for a few minutes or longer. Or, it might beat quickly, then normally and then slowly. The irregular heartbeats of afib are caused by an electrical problem in the heart’s top chambers, called the atria.
Atrial fibrillation is the most common type of heartbeat irregularity or arrhythmia. An estimated 2.3 million to 6.1 million people have afib in the U.S., according to the Centers for Disease Control and Prevention.
Of those, about 10% are over age 65. Afib becomes more common as we age. That’s because the electrical connections of the heart start to break down with age. In addition, chronic diseases associated with afib, such as high blood pressure, are more common as you get older, says Dr. Joseph H. Levine, director of the Arrhythmia and Pacemaker Center at St. Francis Hospital in Roslyn, New York.
[READ: Types of Arrhythmias.]
In addition to age and high blood pressure, other causes of atrial fibrillation include:
— A heart attack.
— Drinking alcohol in excess.
— Drinking too much caffeine.
— Genetic causes. In other words, you may be more likely to develop afib if others in your family have it.
— Having coronary artery bypass or valvular heart surgery. About 25% to 40% of people with these surgeries develop afib afterward.
— Thyroid diseases such as hyperthyroidism and hypothyroidism.
— Sleep apnea. This sleep disorder causes your breathing to start and stop frequently while you sleep.
Symptoms of Afib
Symptoms of afib include:
— An irregular, rapid heartbeat.
— A “thumping” feeling in the chest.
— Feeling more fatigued.
— Shortness of breath.
Not everyone with afib will have symptoms. People with multiple afib symptoms may seek a doctor’s care early on, even within hours after they feel symptoms. Others may not notice an irregular heartbeat but just feel generally fatigued or weaker over a few weeks or months.
There also are people with afib who have no symptoms and happen to have the condition diagnosed during a routine checkup, says Dr. Ralph Augostini, a cardiologist and co-director of the electrophysiology training department and director of ambulatory device clinic at the Ohio State University Wexner Medical Center in Columbus, Ohio.
Atrial fibrillation can increase your chance of having a stroke by up to five times, says Dr. Suzanne Steinbaum, a cardiologist and an American Heart Association volunteer medical expert based in New York City.
The stroke risk increases because with afib because the top chambers of the heart don’t contract adequately, which could lead to the formation of a blood clot. If the clot travels from a heart toward the brain, then a stroke will happen, explains Dr. Sameer K. Mehta, a cardiologist and vascular surgeon with Denver Heart and director of cardiology and co-director of the Amputation Prevention Center at Rose Medical Center in Denver.
Having atrial fibrillation also raises your chances of having heart failure.
Treatment for afib will vary depending on the afib symptoms and the type of uneven heartbeat pattern that you have. Common afib treatments include:
— Catheter ablation therapy. In this outpatient procedure, a catheter is inserted in a leg vein and then guided through vessels to the heart. Wires are then threaded through the catheter, positioned in the heart to target the electrical connections between the pulmonary veins that carry oxygenated blood from the lungs to the heart and the heart’s left atrium. Ablation therapy is 60% to 70% effective at preventing afib over a year, Augostini says. Ablation is more likely to be used if you’ve had multiple afib episodes.
— Medications such as beta blockers, calcium blockers or anti-arrhythmic drugs. Anti-arrhythmic drugs are usually 50% to 60% effective at blocking afib over six months. A doctor also may prescribe an oral anti-coagulant drug if you’re at a higher risk for a stroke.
— Surgical treatments, such as implanting a pacemaker. A pacemaker is a device that helps your heart beat in normal rhythm.
8 Tips for Living Well With Atrial Fibrillation
You can live well with afib by following a few practical tips:
1. Manage your blood pressure.
If you have both high blood pressure (also called hypertension) and atrial fibrillation, you have an even higher stroke risk. That’s because high blood pressure is the most common cause of stroke, Steinbaum says. Check your blood pressure regularly, take your blood pressure medications and follow a heart-healthy diet. Find ways to keep your blood pressure under control. Buy a blood pressure cuff that also reports your heart rate, so you can monitor both numbers regularly, Augostini advises.
A normal resting heart rate is 60 to 100 beats a minute. Your health provider may want you to track your heart rate regularly to look for upward or downward trends in the numbers.
2. Be wary of alcohol and caffeine consumption.
These can trigger symptoms in many people with afib. Up to 300 mg a day of caffeine may be safe for people with heart arrhythmia, according to a 2018 article in JACC: Clinical Electrophysiology. However, it’s best to ask your health provider what’s safest for you.
For alcohol, some guidelines state that up to one drink a day for women and two drinks a day for men is safe, according to the American College of Cardiology. However, the best approach is to avoid alcohol altogether. If you do choose to drink, don’t binge on several drinks in one day or evening, Levine cautions. Drinking several drinks in one time period could lead to afib two or three days later, a condition that’s often called “holiday heart.”
3. Watch for the signs of sleep apnea.
Sleep apnea and afib often go hand in hand, with about 50% of those with afib also having sleep apnea. Treatment of sleep apnea can help lessen your afib occurrences. In fact, there’s so much overlap between these two conditions — as well as heart failure — that the Ohio State University has a special clinic to help manage these patients, Augostini says.
A doctor can order a sleep study and, if you have sleep apnea, recommend the use of a special mask called a CPAP to allow you to breathe better at night.
4. Know the symptoms of a stroke.
Because the risk for a stroke is higher when you have afib, you and those close to you should stay aware of a stroke’s symptoms. The easiest way to remember them is to think FAST, which stands for:
— F: Face drooping.
— A: Arm weakness.
— S: Speech difficulty.
— T: Time to call 9-1-1.
Other stroke symptoms include numbness, confusion, a sudden severe headache and trouble walking or seeing. The quicker a person can get treated for a stroke, the more effective treatment can be.
5. Manage any other chronic health problems you have.
Here’s why that’s important: Diabetes isn’t associated with a higher afib risk, but many people with diabetes also have heart disease and high blood pressure. Those are linked to a higher stroke risk. Having high cholesterol also isn’t associated with afib, but it’s often linked to overall heart disease risk — and that can predispose you to afib.
Exercise regularly and eat a heart-healthy diet to help manage many chronic health problems. A heart-healthy diet includes:
— Healthy fats found in foods like salmon and walnuts.
— Leafy greens and other vegetables.
— Lean protein.
— Whole grains.
6. Lose weight if needed.
If you’re obese or overweight, weight loss can help improve or eliminate other health problems you may have, such as diabetes, hypertension and sleep apnea. Healthy living, including weight loss and regular exercise, can help prevent atrial fibrillation and make it less likely that you will have atrial fibrillation episodes, Mehta says.
7. Use technology to your advantage.
Some smart watches such as the Apple Watch can alert you to an elevated heart rate and obtain a sample of your heart rhythm, Augostini says. The makers of the fitness tracking device Fitbit are studying how to monitor for afib episodes. There are also apps that allow you to monitor your heart rate and record a heart rhythm from your phone. Other apps are available to help you manage your medications and treatments and send you reminders to take meds.
8. Know when to see a doctor.
In addition to regular checkups, there are afib symptoms that should prompt you to schedule a non-urgent doctor’s appointment:
— Your afib symptoms are getting worse.
— You experience dizziness more frequently.
— You’re having more difficulty doing normal exercises or regular activities.
“There may be a change in the heart rhythm or heart damage, and both of these can be critical to diagnose early,” Steinbaum says.
See a doctor immediately if you experience chest pain, heart palpitations and shortness of breath.
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