What you need to know about atrial fibrillation

By Sankar Varanasi, MD  |  9/25/2020

At least 2.7 million Americans have atrial fibrillation (AFib), a quivering or irregular heartbeat that can lead to heart-related complications including stroke, heart failure and blood clots.

A normal heart contracts and relaxes to a regular beat, but in AFib, the upper chambers of the heart, called the atria, beat irregularly, impeding the heart’s ability to effectively move blood into the ventricles. Because of this, a clot can form resulting in a stroke. Between 15 and 20 percent of stroke patients have heart arrythmias. In fact, AFib is associated with a five-fold increased risk for stroke. Despite these statistics, many people are unaware AFib is a serious condition.

SYMPTOMS

While there are people with AFib who have no symptoms, some may experience one or more of the following:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness Shortness of breath and anxiety
  • Weakness Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure

While some of these symptoms are like other heart problems, including cardiac arrest, fluttering and palpitations are the key signals of AFib.

TREATMENT

The treatment for AFib starts with a visit to a cardiologist who can properly diagnose you through an in-depth exam that will likely include an electrocardiogram (EKG or ECG). While treatments may vary depending on the length, severity and cause of your AFib, generally the goal is to reset the heart’s rhythm or control the rate and prevent blood clots.

To reset the heart’s rate and rhythm to normal, doctors may prescribe medications to control your heartbeat. Doctors may also opt to conduct a cardioversion procedure. There are two types of cardioversion: electrical, where an electric shock is delivered to your heart with paddles or patches on your chest, and/or prescribing medications to slow the electrical signals in your heart.

There are times, however, when cardioversion or medications do not work. If that’s the case, a doctor may recommend catheter or surgical ablations. In a catheter ablation, a doctor inserts long, thin tubes (catheters) into your groin and guides them through blood vessels to your heart. The catheter’s tip produces cold or heat to destroy areas of the heart tissue causing the rapid and irregular heartbeats.

Surgical ablation requires open heart surgery and is generally reserved for patients who don’t get better with other treatments or are having cardiac surgery for another reason.

PREVENTION

Because AFib patients are at increased risk of developing blood clots that can lead to stroke, your doctor may prescribe blood-thinning medications to prevent clotting.

Lastly, for both patients with AFib and those looking to reduce their risk of getting it, maintain a heart-healthy lifestyle that includes:

  • Regular physical activity (at least 30 minutes of moderate exercise on most days)
  • Follow a heart-healthy diet that is low in salt, saturated fats, trans fats and cholesterol
  • Avoid excessive amounts of alcohol and caffeine
  • Don’t smoke
  • Maintain a healthy weight and cholesterol level

Dr. Sankar Varanasi is a cardiologist with The Heart Center, a division of Hudson Valley Cardiovascular Practice, P.C., now part of Nuvance Health. For more information on cardiovascular care and The Heart Center, visit www.nuvancehealth.org/heartcenter