More Straight Answers About Atrial Fibrillation

Patient Expert

We've been going back to the basics about atrial fibrillation because so many patients, family and friends have questions. Let's look at some more questions and answers about this most common of heart arrhythmias. We thank the American Heart Association, the Cleveland Clinic, and the American College of Cardiology for their helpful informational materials.

Who gets atrial fibrillation more often - men or women? More men are initially diagnosed with Afib. But women have a higher rate of stroke-related deaths.

Can I have afib and not even know it? Yes. Some people never have symptoms and may not know they have it until diagnosed by a physical exam or an EKG/ECG.

What is the biggest risk of having afib? Stroke is the number one risk of this arrhythmia. Along with that, there may be   eventual heart failure due to the weakening of the heart muscle.

It is important for everyone - not just those with afib - to know the symptoms of a stroke. What are they? Severe headache, dizziness, loss of balance, trouble walking, confusion, trouble speaking or understanding, numbness or weakness on one side of the body or face, and blurry or darkened vision. This is a 911 emergency.

My atrial fibrillation comes and goes.   What are some "triggers" of atrial fib? The most commonly mentioned triggers that seem to bring on an episode of afib are caffeine, alcohol, stress, getting up in the night after being fully asleep, eating MSG, and exercise that raises your heart rate. For many people, afib is constant so they do not notice going in and out of the arrhythmia.

My doctor says I must be on a "blood thinner" to help prevent stroke.   What kind of meds are these? Two kinds of blood thinners - anticoagulants, and antiplatelet agents - reduce clotting in an artery, a vein or in the heart. It is unlikely that afib sufferers will be put on aspirin (an antiplatelet) alone. The concern about strokes with afib is so great that most "afibbers" will be put on an anticoagulant.   An example of an anticoagulant is Coumadin (Warfarin), which requires regular blood testing to be sure you are in the proper range of effectiveness. If you are outside the 2-3 range, your medication is either not effective, or you may have additional bleeding problems, including internal bleeding. In the last few years, three new medications have come online that do not require regular blood testing.   They work similarly and they are marketed under the names Pradaxa, Xarelto, and Eliquis. Afib patients have found them, in general, easy to tolerate and more convenient than the old standby, Coumadin (Warfarin.)

What is the difference between a cardiologist and an electrophysiologist? A cardiologist is trained to diagnose and manage all heart-related conditions. An electrophysiologist is a cardiologist who has had substantial additional training specifically in heart rhythm issues, including atrial fibrillation.

I am worried. Can I die from an episode of afib? In general, no.   You can die from complications, such as stroke and heart failure. If you have other underlying heart issues and are not controlling them, afib may worsen your existing problem.

Is afib curable, or is it permanent? Sometimes afib is curable, or it can be "postponed" for many years. (In my own case, the first time I had afib, a simple cardioversion converted it and I was afib-free for nine years.)   When it is not curable, it is often manageable. Everyone with afib is different, and each needs to be seen by a knowledgeable physician and follow the right treatment plan. Sometimes, afib symptoms have been known to go away on their own.