AFib: Symptoms, causes, treatment

Atrial fibrillationAFib is expected to affect 40 million people worldwide and can be fatal if not treated. UAB experts provide tips on symptoms, risk factors and management of this condition., also known as AFib, is a serious heart condition that affects the rhythm of the heart causing it to beat irregularly. It is estimated to affect 40 million people worldwide and 6 million in the United States alone, according to the Heart Rhythm Society. By 2035, the Centers for Disease Control and Prevention estimates that 12.1 million people in the United States will have AFib.

"AFib puts patients at risk for stroke. Approximately one in five strokes in the United States are associated with AFib," said William Maddox, M.D., a cardiac electrophysiologist at the University of Alabama at BirminghamCardiovascular Institute. "It can also make some patients quite symptomatic with palpitations, dizziness, shortness of breath, chest pain, decreased exercise tolerance and even syncope. When it is seen in conjunction with other cardiac problems, like heart failure, it can lead to increased hospitalizations and an increased risk of death."

Symptoms

AFib occurs when there is an electrical misfiring in the heart, typically due to the pulmonary veins in the left atrium of the heart. Symptoms of AFib include irregular heartbeat, heart palpitations such as rapid, fluttering or pounding, lightheadedness, extreme fatigue, shortness of breath, and chest pain.

Risk Factors

While the risk for AFib increases with age, there are many risk factors that could play a role in people being diagnosed with AFib.

Risk factors include:

• High blood pressure
• Obesity
• Obstructive sleep apnea
• Heart disease
• Diabetes
• Heart failure
• Hyperthyroidism
• Chronic kidney disease
• Moderate to heavy alcohol use
• Smoking
• Enlargement of the chambers on the left side of the heart

Prevention

"To prevent AFib, it is important to maintain a healthy lifestyle with a healthy diet and exercise," Maddox said. "Having good blood pressure control, stopping smoking, and avoiding or moderating your alcohol use can help prevent AFib. If you have sleep apnea, getting the proper treatment for that condition can also help prevent AFib."

People who maintain a healthy lifestyle decrease their likelihood of an episode's happening. While experts do not know the exact triggers of an AFib episode, some patients may find that there is a common factor during their episodes such as heavy stress, alcohol use or dehydration. Maddox says, if an individual notices a common factor that may precede an AFib episode, it is best to try to avoid that trigger, if possible.

Management and treatment of AFib

"Treatment of AFib is twofold," Maddox said. "Managing this condition means taking steps to prevent stroke and to prevent symptoms."

Maddox says those with AFib may be prescribed anticoagulants, which are medications used to prevent blood clots. Patients may also be prescribed medications that decrease the likelihood of AFib's happening and decrease symptoms. Patients who may be intolerant of medications or who have not had success with medications may be able to get a catheter ablation, which is a minimally invasive procedure that can target the triggers of AFib in the heart.

"We have a comprehensive approach to treatment of AFib here at the UAB Cardiovascular Institute," Maddox said. "In patients who are not tolerant of blood thinners, closure of the left atrial appendage via a minimally invasive procedure can decrease the risk of stroke and get them off anticoagulation. Ablation for atrial fibrillation is common here, with approximately 800-900 AFib ablations performed per year."

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