Understanding Atrial Fibrillation (AFib)
Atrial fibrillation (AFib) is a common heart condition that affects many Australians. It's an irregular and often rapid heart rate that can increase your risk of stroke, heart failure and other heart-related complications. In a healthy heart, the upper chambers (atria) and lower chambers (ventricles) beat in a coordinated rhythm. In AFib, the atria beat chaotically and irregularly, out of sync with the ventricles. This can lead to various symptoms and health risks. This guide provides a comprehensive overview of AFib, including its causes, symptoms, diagnosis, treatment options, and tips for living well with the condition.
Causes and Risk Factors for AFib
AFib can be caused by a variety of factors that disrupt the heart's normal electrical activity. Understanding these causes and risk factors can help you take steps to prevent or manage the condition.
Common Causes
High Blood Pressure (Hypertension): Over time, high blood pressure can stiffen and thicken the heart muscle, making it more prone to AFib.
Coronary Artery Disease (CAD): CAD reduces blood flow to the heart muscle, which can damage the heart's electrical system.
Heart Valve Problems: Conditions like mitral valve stenosis or regurgitation can enlarge the atria, increasing the risk of AFib.
Heart Failure: A weakened heart struggles to pump blood efficiently, leading to structural changes that promote AFib.
Congenital Heart Defects: Some people are born with heart defects that predispose them to AFib.
Thyroid Problems: Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid conditions can trigger AFib.
Lung Diseases: Conditions like chronic obstructive pulmonary disease (COPD) and sleep apnoea can increase the risk.
Viral Infections: Some viral infections can inflame the heart muscle (myocarditis) and lead to AFib.
Excessive Alcohol Consumption: Binge drinking or chronic heavy alcohol use can damage the heart and trigger AFib.
Stimulants: Excessive caffeine or other stimulants can sometimes trigger AFib.
Risk Factors
While some causes are unavoidable, several risk factors can be modified to reduce your chances of developing AFib.
Age: The risk of AFib increases with age. It's more common in people over 60.
Obesity: Being overweight or obese puts extra strain on the heart and increases the risk of various heart conditions, including AFib.
Family History: If you have a family history of AFib, you're more likely to develop it yourself.
Chronic Conditions: Conditions like diabetes, kidney disease, and chronic lung disease increase the risk.
Sleep Apnoea: This condition, characterised by pauses in breathing during sleep, can strain the heart and trigger AFib.
It's important to note that some people develop AFib without any identifiable risk factors. If you're concerned about your risk, talk to your doctor. Learn more about Heartresearch and our commitment to cardiovascular health.
Symptoms and Diagnosis of AFib
AFib symptoms can vary widely from person to person. Some people experience noticeable symptoms, while others may not be aware they have the condition. Early diagnosis and treatment are crucial to prevent complications.
Common Symptoms
Heart Palpitations: A fluttering, racing, or pounding sensation in the chest.
Shortness of Breath: Feeling breathless, especially during exertion.
Fatigue: Feeling unusually tired or weak.
Dizziness or Lightheadedness: Feeling faint or unsteady.
Chest Pain: Discomfort or pressure in the chest (less common but can occur).
Weakness: General feeling of being physically weak.
Confusion: Difficulty thinking clearly or concentrating.
It's important to seek medical attention if you experience any of these symptoms, especially if they are new or worsening.
Diagnosis
Diagnosing AFib typically involves a physical exam, a review of your medical history, and diagnostic tests.
Electrocardiogram (ECG or EKG): This is the primary test for diagnosing AFib. It records the electrical activity of your heart and can identify irregular heart rhythms.
Holter Monitor: A portable ECG that you wear for 24-48 hours (or longer) to record your heart's activity over an extended period. This is useful for detecting AFib that occurs intermittently.
Event Recorder: A device you wear for several weeks that records your heart's activity only when you experience symptoms. You activate the recorder when you feel palpitations or other symptoms.
Echocardiogram: An ultrasound of the heart that provides information about its structure and function. It can help identify underlying heart conditions that may be contributing to AFib.
Blood Tests: Blood tests can help rule out other conditions that may be causing your symptoms, such as thyroid problems or electrolyte imbalances.
Your doctor will use the results of these tests to determine if you have AFib and to assess the severity of your condition. Understanding your diagnosis is the first step towards effective management. Many patients have frequently asked questions about their diagnosis.
Treatment Options for AFib
The goals of AFib treatment are to control the heart rate, prevent blood clots and strokes, and restore a normal heart rhythm. Treatment options vary depending on the severity of your symptoms, the underlying cause of your AFib, and your overall health.
Medications
Rate-Control Medications: These medications slow down the heart rate to a more normal range. Common examples include beta-blockers (e.g., metoprolol, atenolol) and calcium channel blockers (e.g., diltiazem, verapamil).
Rhythm-Control Medications: These medications aim to restore and maintain a normal heart rhythm. Examples include antiarrhythmic drugs like amiodarone, flecainide, and propafenone.
Anticoagulants (Blood Thinners): These medications reduce the risk of blood clots and stroke. Common options include warfarin (a vitamin K antagonist) and direct oral anticoagulants (DOACs) like dabigatran, rivaroxaban, apixaban, and edoxaban. Your doctor will assess your stroke risk and bleeding risk to determine if you need an anticoagulant and which one is most appropriate for you.
Procedures
Cardioversion: This procedure uses electrical shocks or medications to restore a normal heart rhythm. It can be performed as an elective procedure or in an emergency situation.
Catheter Ablation: This minimally invasive procedure uses radiofrequency energy or cryoablation (freezing) to destroy the areas of the heart tissue that are causing the irregular heart rhythms. It's often used for people who don't respond well to medications or who have frequent AFib episodes.
Pacemaker Implantation: In some cases, a pacemaker may be implanted to regulate the heart rhythm, especially if medications or ablation have slowed the heart rate too much.
Left Atrial Appendage Closure (LAAC): This procedure involves closing off the left atrial appendage, a small pouch in the heart where blood clots are likely to form in people with AFib. This can reduce the risk of stroke without the need for long-term anticoagulation medication. Our services include assessment for LAAC suitability.
The choice of treatment will depend on your individual circumstances and preferences. Your doctor will discuss the risks and benefits of each option with you to help you make an informed decision.
Living with Atrial Fibrillation
Living with AFib requires ongoing management and lifestyle adjustments to minimise symptoms and reduce the risk of complications. Here are some tips for living well with AFib:
Follow Your Doctor's Instructions: Take your medications as prescribed and attend all scheduled appointments.
Monitor Your Heart Rate and Rhythm: Learn how to check your pulse and recognise the signs of AFib. Keep a record of your symptoms and share them with your doctor.
Manage Underlying Conditions: Control high blood pressure, diabetes, thyroid problems, and other conditions that can contribute to AFib.
Maintain a Healthy Lifestyle: Eat a heart-healthy diet, exercise regularly, maintain a healthy weight, and avoid smoking.
Limit Alcohol and Caffeine: Excessive alcohol and caffeine can trigger AFib episodes. Talk to your doctor about safe limits for you.
Manage Stress: Stress can worsen AFib symptoms. Practice relaxation techniques like yoga, meditation, or deep breathing exercises.
Get Enough Sleep: Aim for 7-8 hours of sleep per night. Treat sleep apnoea if you have it.
Stay Hydrated: Dehydration can sometimes trigger AFib. Drink plenty of water throughout the day.
Know Your Stroke Risk: Understand your stroke risk and take steps to reduce it, such as taking anticoagulants as prescribed.
Seek Support: Join a support group or talk to a therapist to cope with the emotional challenges of living with AFib.
Living with AFib can be challenging, but with proper management and lifestyle adjustments, you can live a full and active life. Regular communication with your healthcare team is essential for optimising your treatment plan and addressing any concerns you may have. Remember to consult with your doctor or other qualified healthcare professional for any questions you may have about your medical condition or treatment. Heartresearch is dedicated to advancing cardiovascular health and providing valuable resources for patients and healthcare professionals alike.