Atrial fibrillation, an irregular and often rapid heartbeat, is a common malady in Americans that can lead to many different problems if it's not treated, says Dr. Michael Goldstein, a cardiologist at Anne Arundel Medical Center. Obesity and high blood pressure may play roles, though it's not entirely clear why some people develop it. But if it's identified, there are ways to treat it and keep it from becoming a major health issue.
What is AFib and how common is it?
Atrial fibrillation, also known as AFib, is a common cardiovascular disease. It is a chronic condition that affected 5.2 million people in 2010 and is estimated to increase to 12.1 million by the year 2030. As a result, atrial fibrillation is a serious health concern in the United States and globally.
What are thesymptoms, and how is it diagnosed?
Symptoms of atrial fibrillation are extremely variable. Some people do not have any symptoms, while others have symptoms such as shortness of breath, chest pain, swelling of the legs, rapid heartbeat and even strokes. AFib can be diagnosed as part of a routine checkup with a doctor — that is why these visits are so important. Usually AFib issues will show up on an electrocardiogram. But sometimes people have symptoms that suggest AFib or have a stroke without identifiable causes. Doctors are able to diagnose AFib using Holter monitors or implanted cardiac monitors, called loop recorders, to identify the causes of these symptoms.
If left untreated, AFib can cause a decreased quality of life, strokes or a weakened heart muscle called cardiomyopathy.
Does it ever go away on its own, or does it always require treatment?
AFib is usually a long-term problem. Some people have atrial fibrillation that comes and goes or atrial fibrillation that lasts longer periods of time, typically greater than one week.
Once atrial fibrillation develops, there are multiple treatment methods. There are medications to suppress atrial fibrillation as well as medications to control the heart rate. In certain circumstances, pacemakers can be used. There is a minimally invasive procedure called an ablation of atrial fibrillation, which is a procedure that alters tissue in the heart to help suppress AFib.
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Of all treatments for atrial fibrillation, the most important is identifying patients at risk for a stroke and then initiating medical therapy to prevent a stroke. Patients who are low risk require aspirin. Patients at an increased risk require one of the many prescription oral anticoagulants (medicines that reduce blood-clotting in an artery, a vein or the heart).
Certain patients are unable to take medications to thin the blood and prevent blood clot formation. A novel implanted device has been approved by the U.S. Food and Drug Administration to treat these patients. This is called the Watchman device. It is implanted via a minimally invasive procedure performed to occlude a small appendage in the top left chamber of the heart (left atrial appendage) to prevent blood clots from forming. Despite recent advertisements on television, these blood-thinning treatments have been demonstrated to be safe and highly effective at preventing devastating strokes from atrial fibrillation.
Can it be prevented?
There are risk factors that have been shown to contribute to the development of atrial fibrillation. These include obesity, diabetes, hypertension (high blood pressure) and sleep apnea. Unfortunately there has been no single cause identified. As a result, patients with AFib are encouraged to make lifestyle changes to better manage other health issues that may contribute to AFib.
If you believe you have atrial fibrillation or if you have any questions, seek consultation with your health care provider. Patient participation in the diagnosis and management of atrial fibrillation is critical in preventing unnecessary complications.