Straight Answers about Atrial Fibrillation

Patient Expert

Do you know what atrial fibrillation is? Do you have questions about it?  Sometimes, in the midst of all of our updates, treatments, medications, surgeries and discussions for and about this most common heart arrhythmia, we forget that more of us are being diagnosed with atrial fibrillation every day, and new people to the condition may have some basic questions.  So, today we'll answer some basic atrial fibrillation questions:

What is atrial fibrillation and who gets it?

The most common heart rhythm disturbance in the US, affecting nearly 3 million people, atrial fibrillation (afib) is estimated to affect more than 4 percent of the total population over age 65 and 12 percent over the age of 80, but it is not limited to our older population and can affect an individual at any time of life. Afib is characterized by disorganized electrical activity in the heart that originates in the upper chambers (atria) causing quivering and a rapid heartbeat, along with a range of uncomfortable and frightening symptoms.

Will I die from atrial fibrillation?

Atrial fibrillation is not considered life-threatening. However, its effects can cause serious and life-threatening conditions such as heart failure, and, most commonly, a stroke. Afib patients have a five times higher risk of stroke due to clot formation, and this is why blood thinners are commonly prescribed for those who have atrial fibrillation either persistently or paroxysmally (afib that comes and goes.)

What does atrial fibrillation feel like?

The symptoms of afib vary widely, not only from patient to patient, but often from day to day in the same patient. There is an entire panoply of advice and anecdotal sharing between patients, as well as web sites where information is shared and suggestions given. The most common symptoms of the irregular heart rhythm are rapid heartbeat, palpitations, dizziness, light headedness, fatigue, fainting, and anxiety. Many sufferers complain that their regular routines and activities are limited not just by the irregular rhythm, but by the side effects of medication they may be prescribed to manage it. Some afib patients must go to the ER if their heart rate "takes off" and runs above 150 beats per minute. Surprisingly, however, many who are diagnosed with afib have no idea they had it, and have no symptoms whatsoever. That is what makes afib a dangerous condition because the clotting and stroke danger still exists and is not being treated.

Why did I get atrial fibrillation?

This appears to be the big question among doctors and researchers who can point to some likely reasons but not others. Your heart may be "too electrical," offering up wandering and disorganized electrical waves from several areas, or, sometimes, from one or two spots in the pulmonary veins. Other conditions may predispose one to afib: thyroid disease, valvular heart disease, high blood pressure, or congestive heart failure. But, a large portion of afib diagnoses are for no particular reason at all - these are called "idiopathic," meaning no one knows the reason.

Does afib ever just go away by itself?

Yes. Many people have episodes of what is called "lone afib," in which they only have one episode. Some people have bouts of afib and then long periods in between in normal sinus rhythm. Others can have persistent, or even permanent, afib. The problem with afib, however, is that it is likely to return, and the more times a heart spends in atrial fibrillation, the more it tends to "remodel" itself into the arrhythmia. For this reason, the saying "afib begets afib" is a popular one with cardiologists.

There are many other questions you may have about atrial fibrillation. One of the more complicated categories involves anticoagulation and blood thinners. There is interest in how to "cure" or "fix" atrial fibrillation and what techniques or medicines can be used. Lifestyle changes and adaptations is another important topic. We will explore all of these in the second part of this post next time.