Out of rhythm

If doctors knew why certain people suffer from atrial fibrillation, it’d be a lot easier to treat. Instead, the causes are mysterious. However, you can lower your chances for Afib episodes by managing the risks commonly tied to them. These include medical conditions and, in some cases, triggers.

“Pay attention and see if there's something you can associate with your Afib,” said Christopher Austin, MD, a cardiac electrophysiologist with Baptist Heart Specialists. “Occasionally, people will notice something. They’ll say, 'Yeah, when I drink red wine' or 'when I go outside and mow the lawn in the middle of summer, it puts me into an Afib episode.'”

Recognizing symptoms of Afib

Afib is a type of heart arrhythmia – a condition that causes the heart to beat irregularly. These episodes can feel as mild as a slight fluttering or as intense as feeling like your heart is beating through your chest. Or there may be no symptoms at all, just a notification from your smartwatch warning you that your heart is beating irregularly. Depending on what type of arrhythmia you have, you may experience extra heartbeats, fewer heartbeats or a burst of very fast heartbeats.

If the arrhythmia is caused by Afib, the heart rhythm will be very disorganized.

“If one extra heartbeat is like the ripples from a stone you threw in a lake, then Afib is like all of the ripples colliding into each other from throwing 50 pebbles,” Dr. Austin said.

What’s the risk?

Having an Afib diagnosis is similar to having a high blood pressure diagnosis, Dr. Austin said.

“It’s a chronic condition but is rarely life-threatening by itself,” he said.

People with Afib need to manage symptoms, though, because having Afib significantly increases the risk of stroke and can lead to other serious problems. Afib makes the heart’s upper chambers beat out of sync with the lower chambers. This can cause blood to pool up and drain passively. Blood clots may form, and these clots can potentially break off and travel to the brain, causing a stroke. Afib can also overwork the heart, and that can lead to heart disease.

Getting Afib under control

To manage Afib, electrophysiologists use several tactics. One is to identify and treat any medical conditions known to increase the risk for episodes. The most important of these is sleep apnea, Dr. Austin said. Treating it can lower your frequency of Afib episodes by as much as half.

“The association is so important that everyone diagnosed with Afib should be screened for sleep apnea whether they think they have it or not,” Dr. Austin said. “If you have it and you don’t treat it, that’s a missed opportunity.”

Other conditions, like diabetes, high blood pressure and obesity, also increase your risk for Afib episodes and should be managed.

For up to 75% of patients, Afib can be correlated to triggers. Some known ones include:

• Alcohol consumption, especially binge drinking
• Excessive exercise
• Lack of sleep
• Stress

If any of these activities connect to your Afib symptoms, try to avoid them. If that doesn't bring Afib under control, doctors may also try catheter ablation. This procedure creates tiny “scars” in the heart that block faulty electrical signals.

Afib can progress the more it occurs, from short episodes that self-resolve to longer episodes that require medical intervention. Because of this, you’ll want to lower the overall number of Afib episodes you have.

“The most important thing with Afib is identifying that you have it,” Dr. Austin said. “Our patients do better in the long run if we catch it early because then we can lower their risk.”