AFib Looks Different In Women: What You Should Know

Millions of women and men in the U.S. have atrial fibrillation (AFib), a condition that causes the heart to beat too slowly, too quickly or irregularly. But the disease affects women differently than men.

"Not only can risk factors and symptoms of AFib be different between men and women, but treatment recommendations may be different as well," says Ali Shakir, M.D., a cardiologist and electrophysiology specialist at Henry Ford Health. "The importance of identifying and treating AFib in patients is to reduce your risk of stroke and improve your quality of life."

If you're a woman at risk for AFib, knowing these distinctions can help you stay healthy.

Atrial Fibrillation Risk Factors

AFib can be diagnosed at any age. While your risk for it increases with age, some health conditions such as thyroid disease or sleep apnea can increase the risk in younger adults.

There are, however, different factors between men and women that increase the risk of developing a heart rhythm disorder:

• In women, high blood pressure and heart valve disease are more likely to lead to AFib.
• In men, coronary artery disease and previous heart attack are more common risk factors for AFib.

AFib Symptoms In Women

For both sexes, typical symptoms of AFib include:

• Racing heart rate
• Palpitations (a feeling that your heart is fluttering or skipping a beat)
• Shortness of breath
• Chest pain

Yet men and women often experience AFib differently:

• Atypical symptoms. Women are more likely than men to experience less-common symptoms of AFib such as fatigue and weakness.
• Frequency and duration of episodes. Women tend to have more frequent and longer-lasting AFib episodes than men.
• Stroke risk and severity. Women with AFib may be at higher stroke risk than men. And when women have a stroke, it tends to be more severe.

AFib Treatments: What Women Should Know

When it comes to treating AFib, Dr. Shakir notes that treatments are separated into two different categories: symptom reduction and AFib correction. Not everyone is a candidate for each type of treatment, though. While all AFib treatment options are safer and more effective than ever before, women are likely to have more complex cases compared to men.

As the name would indicate, symptoms reduction methods of AFib treatment are designed to keep symptoms under control to improve a patient's quality of life. These methods may include:

• Medications. Your doctor can prescribe different types of medications that can lessen the intensity of your AFib symptoms.
• AFib suppression. Antiarrhythmic medications can help suppress AFib symptoms by regulating heart rhythm patterns. In some cases, women using these prescriptions are more likely to experience heart rate problems in the bottom chamber of the heart.
• Ablation. This minor procedure targets the heart tissue that generates an irregular heart rhythm. Your doctor will create tiny scars in this area of the heart to disrupt the signals causing AFib. Women tend to undergo ablation less often than men. "When women do get ablation, they tend to have had AFib for a longer time," Dr. Shakir says. "As a result, women often need more complex procedures."

AFib Correction

These treatment options are used to minimize the effects of AFib on the body by focusing on reducing your risk for stroke. With both options however, your ability to tolerate these treatments is based significantly on your risk for falls or injury.

• Blood thinners. "Blood thinners are most effective at reducing your risk of stroke," says Dr. Shakir. "While women tend to be at a greater risk of stroke compared to men, older women can be at a greater risk of bleeding from blood thinners."
• Left atrial appendage closure. In this procedure, your doctor will close off the left atrial appendage, a small pouch in the left atrium of the heart. This prevents blood clots from entering into the bloodstream and causing a stroke.

Staying Healthy With AFib

AFib isn't something anyone should ignore. But women, in particular, should pay close attention to the signs and symptoms. "Women tend to have more frequent and longer-lasting episodes of AFib, and they are more likely to have severe strokes," Dr. Shakir says. "This is often because women downplay their AFib symptoms and put off getting on medication or scheduling sugery."

That doesn't mean women should panic.If you notice changes in your health, talk to your doctor. After diagnosis, AFib can be managed with proper treatment. "The lesson is that women shouldn't ignore any of their symptoms, and they should take AFib seriously even at the early stages," says Dr. Shakir,

Reviewed by Dr. Ali Shakir, a cardiologist and electrophysiology specialist who sees patients at Cardiovascular Institute of Michigan PC in Roseville and Clinton Township.