Atrial Fibrillation: America's Most Common Abnormal Heart Rhythm

Patient Expert

The first thing I noticed about atrial fibrillation had nothing to do with my heart or chest.   The first thing I noticed was that my lips for some reason felt tingly.   I would only notice this in the evenings, when I had settled down and was watching television. My lips would have a strange cold, stingy  sensation. After a couple of days of this, I decided I must be anxious and hyperventilating.   Always one to go searching for clues about medical questions on the net, I began looking up "tingly lips" and sure enough, right after "kissing Brad Pitt" one of the main causes was overbreathing.

So I told myself that I had been under a lot of stress. Earlier in the year, I had been the major caregiver for a family member who had a flare of Crohn's Disease. It took months to resolve the crisis, so naturally, I thought  I was still feeling the anxiety.

But there were other things I began to notice: unusual breathlessness when I was taking my daily walk, and a feeling of adrenaline rushing through my chest area. It is difficult to explain just how this felt - but I began to pay attention.   One evening, meeting clients for dinner, I felt extremely physically anxious and wondered why on earth I was so nervous in what was usually a comfortable situation for me. The feeling passed as we enjoyed cocktails and dinner together.

But a couple of days later things came to a head. I was just back from my walk, and had a feeling in my chest of adrenaline I just could not ignore. I decided to go immediately to my cardiologist's office and have an ekg, just to be sure everything was all right.

But it wasn't.

I learned I was in an abnormal heart rhythm called atrial fibrillation.   More than two million Americans are diagnosed with this condition, and many more probably have it and don't know it.   Although atrial fibrillation can be very uncomfortable and unpleasant, causing the heart to race or creating a "squirrels running around  in a bag" feeling in the chest, it can sometimes be so mild as to be unnoticeable.  Whether it's mild or severe, it is a health issue to be taken very seriously.

Atrial fibrillation (or afib) becomes more common as we age, but young people get it too. One of the most common causes is after  partying hearty (called "holiday heart") and consuming an unusually large amount of alcohol. That kind of atrial fib usually resolves after minor treatment.

The most serious consequence of afib is stroke.   In fact, afib increases the likelihood of stroke by five times, as it makes the formation of a blood clot in the left atrium of the heart more likely. Most doctors will recommend blood thinners (such as Coumadin) for patients in afib. The first question my cardiologist asked me was "When did you notice the symptoms?"   Because I had mostly ignored the strange feelings I was having, I could not answer. Had I been able to pinpoint the start of afib, and come in right away, the doctor might have been able to perform an immediate cardioversion. Now, I would have to take blood thinners, digoxin, additional beta blockers, live with my afib  and wait for at least a month to six weeks before a cardioversion could be attempted.   In that time, we would discover what the cause of my atrial fibrillation was.  I was lucky.  Not everyone gets such a clear answer.

(Next week I'll talk about what causes atrial fibrillation, how it feels, the debate between "rate" and "rhythm" ...  and treatments, even cures for afib.)