Finding the Right Rhythm
Understanding Atrial Fibrillation and What It Means for Heart Health
The Centers for Disease Control estimate that nearly ten percent of people ages 65 and older are living with atrial fibrillation – commonly known as AFib. It is believed that within the next nine years, more than 12 million Americans will have AFib.
While AFib is the most frequently diagnosed heart arrhythmia and is increasingly common, it can be difficult to understand what it is and why it can be so dangerous to our health.
“Atrial fibrillation is an irregular heart rhythm that starts from the top part of the heart,” explains Maheer Gandhavadi, MD, a Cardiac Electrophysiologist with the Dignity Health Heart and Vascular Institute. “Instead of beating normally and smoothly, the top chambers of the heart become electrically disorganized. This causes the heart to beat irregularly.”
Dr. Gandhavadi says some people with AFib experience no symptoms at all. In fact, it can go undetected until a doctor finds it as part of a routine physical exam or during an unrelated medical procedure.
However, many people do experience symptoms which can be alarming.
“Symptoms can range quite a bit and include
palpitations, chest discomfort, shortness of breath, and dizziness,” Dr. Gandhavadi says. “Sometimes symptoms are more subtle, such as an increase in fatigue or decrease in stamina.”
AFib is considered a serious condition because it can lead to potentially life-threatening blood clots.
“Because the top chamber of the heart is beating irregularly, blood clots can form in those chambers — specifically in a part of the heart called the left atrial appendage,” says Dr. Gandhavadi. “These blood clots can leave the heart and even travel to the brain resulting in a stroke, which is the biggest risk of having atrial fibrillation.”
There are several factors that can put you at increased risk for AFib, including high blood pressure, coronary artery disease, untreated sleep apnea, and excessive alcohol use. Men are more likely to develop AFib and risk increases with age.
“While there are multiple risk factors for developing atrial fibrillation, it can affect a wide variety of individuals, many of whom have none of these risk factors,” explains. Dr. Gandhavadi. “We often see atrial fibrillation in people who are quite healthy and who live very normal, active lives.”
Fortunately, there are treatment options available for AFib.
“There are two things to consider when treating atrial fibrillation,” says Dr. Gandhavadi. “The first is to assess the risk of stroke from the atrial fibrillation and the second is to determine whether further treatment is necessary to get the heart back into a regular rhythm.”
The first priority is to make sure that the risk of clots forming is reduced as much as possible. Those people who are at high risk of blood clots from their atrial fibrillation are often prescribed special blood thinning medication, called anticoagulants. These medications thin the blood and significantly reduce the risk of blood clots forming.
For patients who are at higher risk of blood clots and strokes but who cannot tolerate these blood thinning medications, a special device can be implanted that can prevent the clots from forming. The device is implanted via a minimally invasive procedure.
For someone whose AFib is causing symptoms, treatment to restore normal heart rhythm may be needed. This treatment may include medication; a cardioversion, which is a procedure to electrically reset the rhythm; or a cardiac ablation, which is a minimally invasive procedure that treats the areas of the heart that are responsible for triggering the AFib.
Pacemakers are typically not used in the treatment of AFib because they treat slow heartbeats and AFib generally causes fast and irregular heartbeats. However pacemakers can be helpful for some patients who have AFib and issues with slow heart rates.
Dr. Gandhavadi says the prognosis for most patients diagnosed with AFib is quite good.
“There is no reason that anyone with atrial fibrillation can’t lead a healthy life,” he says. “As long as you take care of yourself, address your overall health, and follow up with your doctor regularly, you should do well.”
And he says, hearing a diagnosis of AFib should not be overwhelming.
“AFib doesn’t have to be scary,” Dr. Gandhavadi says. “AFib won’t cause you to have a heart attack. The biggest risk from AFib is the risk of blood clots and that is something that we can prevent. We have amazing treatment options to make sure that your AFib is handled in a way that is best for you and your life. If you have AFib or think you may have AFib don’t hesitate to seek assistance.”
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