Atrial Fibrillation: Don’t dismiss this common heart condition

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According to a study published in the Journal of the American Heart Association, people over age 40 have a 1-in-4 lifetime risk of developing atrial fibrillation.

Often referred to as “AFib,” this irregular heartbeat increases risk of stroke by five times and doubles the risk of heart-related deaths. Unfortunately, it’s estimated that up to half of all patients don’t realize they have this common heart condition. AFib is treatable and beatable, but awareness is key.

How AFib Affects the Heart

AFib is the most common sustained heart arrhythmia.

AFib may occur in brief and intermittent episodes, or it may be a persistent condition. It causes a rapid and chaotic heartbeat in which the atrial electrical signals can increase as high as 350 to 600 beats per minute.

In this case, the upper chambers of the heart, or atria, do not contract properly and blood pools in a cavity known as the left atrial appendage. The pooled blood can form a clot that travels to your brain’s arteries, interrupting blood flow and leading to a stroke. Moving down to the lower chambers of the heart, or the ventricles, AFib can drive a fast and irregular ventricular contraction, which is reflected in an irregular and often rapid pulse. This irregularity in the pulse often results in symptoms of palpitations, fatigue, breathlessness and even reduced cardiac function (i.e., congestive heart failure).

Signs and Symptoms of AFib

AFib affects millions of Americans, but because many don’t experience any symptoms, the condition often goes undiagnosed. These patients are only diagnosed through regular exams and screenings.

For those who do experience AFib symptoms, these can include irregular heartbeat or palpitations, lightheadedness or dizziness, shortness of breath, faintness or confusion, extreme fatigue and/or chest discomfort.

Many patients may dismiss these warning signs, especially if they seem to come and go or only last a short time. It’s important to never take any risks with your heart. If you notice any of these symptoms, contact your physician immediately — and if you are in any sort of distress, such as severe respiratory difficulty or severe lightheadedness, call 911.

Causes and Risk Factors

AFib is most common in patients over age 65. Additional risk factors for developing atrial fibrillation include obesity, high blood pressure, sleep apnea, coronary artery disease, congestive heart failure, valvular heart disease, rheumatic heart disease, diabetes or metabolic syndrome, lung disease or kidney disease.

A family history of AFib can also be important, especially if it affects multiple family members at unusually young ages. However, AFib is so common that having a relative with AFib only slightly increases your chances.

Certain behaviors can also increase your risk for AFib. These include smoking and alcohol abuse. High stress levels and mental health conditions can also be a factor in atrial fibrillation.

Latest Treatment Options

Here in Northeast Florida, we’re privileged to have access to cutting-edge treatments and technology, especially in the area of heart disease.

My team of cardiologists at Ascension St. Vincent’s are highly experienced in catheter ablation for AFib. This is a non-surgical procedure that blocks abnormal electrical impulses causing the irregular heartbeat. It has been proven to perform more effectively than medication for some patients.

However, every case of AFib is different, which is why a tailored treatment plan is essential.

As mentioned, it is important to reduce the risk of stroke for patients with AFib. While warfarin was the standard treatment, my team participated in all the major studies leading to approval of newer anticoagulants that do not have food interactions, do not require close monitoring and are now the standard of care.

Many patients can manage AFib with oral blood thinners to reduce the risk of stroke. Unfortunately, anticoagulants carry a small risk of unintended bleeding which can become problematic for certain individuals.

At Ascension St. Vincent’s, we also perform procedures with the WATCHMAN device that allow us to reduce the risk of stroke without putting patients at risk for increased bleeding.

Most recently, my team became the first in Florida and one of the first in the world to begin enrolling patients in the CHAMPION-AF Clinical Trial. We also did early trials of the second generation WATCHMAN, called the WATCHMAN FLX, and it is now in routine use at our center.

Take some time to discuss AFib with your loved ones. By raising awareness for this common heart condition, more people can find treatment to reduce their stroke risk and improve their quality of life. If you or a loved one may have a heart rhythm disorder, speak to your primary care doctor or cardiologist today.

Dr. Anthony Magnano is a Ponte Vedra resident and chief of cardiology at Ascension St. Vincent’s Riverside. For more information on Magnano and his specialty treating atrial fibrillation, go to Healthcare.ascension.org.