By and large cardiologists will recommend long-term treatment with anticoagulants (warfarin) when your AF is “recurrent” or “persistent.” Even in cases of “paroxysmal” Atrial Fibrillation long-term anticoagulation may be indicated and recommended by your cardiologist.
Why Me? Or What Causes Atrial Fibrillation
Carl’s question as to why he was relatively healthy and still got AF is a good one. The cause of Atrial Fibrillation is generally believed to be scaring of the atrial chambers and loss of atrial muscle mass due to damage of the heart.
The medical term for scarring of the atrium is called fibrosis. Scarring (fibrosis) is caused by numerous conditions that afflict the heart.
Causes of Atrial Fibrillation
High blood pressure
Valvular heart disease (Leaky or narrowed heart valves)
Coronary heart disease- cholesterol blockage of arteries
Heart failure
Weakened heart muscle- cardiomyopathy
Atrial dilation (enlargement) from any cause: obesity, Mitral regurgitation, Tricuspid Regurgitation, Aortic Stenosis, Mitral Stenosis, hypertrophic cardiomyopathy,
Aortic Regurgitation
Pulmonary Vein dilation
Inflammatory conditions of the heart
Even aging may lead to Atrial Fibrillation
Ultimately, damage and abnormality of the atria upsets the normal conduction of electrical activity through the heart. Many theories exist as to “why” Atrial Fibrillation is actually triggered and then become sustained. These reasons don’t influence treatment.
For people with Atrial Fibrillation the important thing is to try to determine if there is something they can do to alter/prevent the conditions that cause this unfortunate rhythm problem.
In Carl’s case, he was overweight, suffered from high blood pressure, and consumed a
large amount of alcohol on a regular basis. Hypertension and excessive alcohol consumption are known to be implicated in Atrial Fibrillation. Hypertension can be controlled by medications, exercise, and other lifestyle changes. A person can choose to discontinue or reduce their alcohol consumption.
So in theory, Carl might be able to successfully eliminate his Atrial Fibrillation and return to a normal cardiac rhythm.
Some of the other causes of Atrial Fibrillation can also be treated. Valvular conditions, coronary heart disease, and even heart failure can be amendable to therapy. Consult your doctor to find out what may have caused your Atrial Fibrillation.
“Why me” is a common question asked by people with Atrial Fibrillation.
I hope this has increased your interest in this common cardiac problem.
Dr. Kirk Laman
Wholehearted Cardiologist
