A Personal Perspective on AFib

“Atrial fibrillation (AF or AFib) is the most common irregular or abnormal heart rhythm disorder that starts in the atria, affecting more than 3 million Americans today,” write experts at Cleveland Clinic, a top American hospital for cardiology and heart surgery.

The medical perspective on AFib

To understand atrial fibrillation, it can be helpful to first understand how a healthy heart works.

“The (heart’s) electrical impulse begins in the sinoatrial (SA node), located in the right atrium,” explain the Cleveland Clinic experts. “Normally, the SA node adjusts the rate of impulses, depending on the person’s activity. When the SA node fires an impulse, electrical activity spreads through the right and left atria, causing them to contract and force blood into the ventricles. When the SA node is directing the electrical activity of the heart, the rhythm is called ‘normal sinus rhythm.’ The normal heart beats in this type of regular rhythm about 60 to 100 times per minute.”

So what is different in a person with AFib?

“Instead of the impulse traveling in an orderly fashion through the heart, many impulses begin at the same time and spread through the atria, competing for a chance to travel through the AV node,” notes Cleveland Clinic experts. “The AV node limits the number of impulses that travel to the ventricles, but many impulses get through in a fast and disorganized manner. The ventricles contract irregularly, leading to a rapid and irregular heartbeat.”

In plain English, that means a host of symptoms for the individual including: feeling a faster than normal beat, a series of skipped beats, or a prolonged racing heart rate that starts on its own with no increase in physical activity level. The person may also feel light headed or dizzy.

Related: Anderstanding AFib

“It’s a bum, bum-bum, bum-bum-bum, bum-bum- bum-bum-bum. So what you’re having is you’re having heartbeats that are going sooner or shorter – bum-bum – or longer – bum-bum-bum, bum. And what that’s doing is it’s altering the ability of your heart to fill and your heart to pump blood effectively,” says Christopher DeSimone, a Mayo Clinic cardiologist.

And yet, as scary as it is to feel these symptoms, most cardiologists will reassure their patients that AFib, itself, is not necessarily dangerous. Often patients are unaware they even have atrial fibrillation.

“Sometimes they’ll describe to me that they feel fatigued. They’re more short of breath. They feel like they’re getting older. They feel like they haven’t been as active. But really what they’re feeling is not effective blood pumping,” says DeSimone. The biggest danger with the condition, he adds, is that it can put patients at greater risk of blood clots, heart failure, and stroke.

There are several types of atrial fibrillation. One is paroxysmal, a single occurrence or occasional episodes. Another, persistent, lasts for at least seven days in a row and needs treatment to stop. Symptoms, including racing heart palpitations or your heart skipping a beat, can occur daily for several minutes or even hours (or not at all). Chronic, or permanent, AFib can continue for years. Managing the condition can help prevent more severe complications.

A personal perspective on AFib

The risk of atrial fibrillation increases with age, particularly after age 60. Also, there is some evidence that AFib is hereditary and runs in families. Genetic AFib is called familial atrial fibrillation.

This is definitely true in my own family, where I and at least three of my siblings, so far, have been diagnosed with AFib. So has my son, who is in his late 30s. Although not related to me, my best friend’s husband and my son’s father-in-law have also been recently diagnosed with the condition. Doctors expect AFib could affect as many as 12 million people by the start of the next decade, the Mayo Clinic notes.

What is sometimes confusing is there is no one-size-fits-all treatment for AFib.

Two of my sisters and my son have had ablation treatments (where a catheter is inserted into the heart and energy released to create scar tissue that will eventually block the ill-timed beats). One sister has a Watchman device implanted (which plugs up the area where clots may form). My brother has an implanted pacemaker (which regulates a slow heart rate). I am currently taking an antiarrhythmic drug along with a beta blocker.

“Although asymptomatic in the vast majority of patients, AFib can manifest as ischemic strokes, leading to hospitalizations, and death,” says the National Institute of Health. AFib is associated with a five-fold increase in the stroke risk.

It is because of this increased stroke risk that blood thinners are routinely prescribed for many AFib patients. Taking blood thinners can increase the risk for bleeding that is hard to control following an accident or fall, but most medical professionals feel the benefits outweigh the risks. As a cardiologist once told me, “we can stop your bleeding much easier than stopping your stroke.”

It is important to have regular visits with a cardiologist after a diagnosis of AFib.

Finally, experts agree there are things a patient can do on their own to help control their AFib episodes. These lifestyle changes include things like avoiding activities that bring on symptoms (for me, this includes heavy lifting or moving furniture); limiting stress; quitting smoking; limiting alcohol intake; cutting out caffeine; being aware of stimulants in some over-the-counter medications like cough and cold remedies; and exercising regularly.