AFib, or atrial fibrillation, is a heart condition defined by a rapid irregular heart rhythm called arrhythmia. In fact, it is the most common heart rhythm disorder worldwide and results in about 750,000 hospitalizations per year in the US alone. AFib has multiple different causes which result in disorganized electrical signals that develop in the top chambers of the heart known as the atria. It can lead to stroke, heart failure, and significantly reduced quality of life. AFib is the cause of stroke in approximately one of seven cases (15-20%), and it can often be silent before it is deadly.
Since it was first discovered, we’ve learned a lot about what causes AFib and what treatments work the best. Today the prognosis for many individuals with AFib is actually quite good with proper care. Thriving in life with atrial fibrillation starts with awareness and education, particularly when it comes to the twelve major points to know about this common illness (see below).
What to Do After an AFib Diagnosis
So you or someone you know has AFib—now what? The first thing to do is to make an appointment with a specialist, called a cardiac electrophysiologist (EP).
What is an electrophysiologist?
An EP is a cardiologist with advanced training in diagnosing and treating heart rhythm disorders. This type of physician is also referred to as a heart rhythm specialist or an arrhythmia specialist. An EP can help you or your loved one navigate the next steps with treating and managing AFib.
Meet Dr. Desai
Hello! My name is Dr. Aseem Desai and I am a cardiac electrophysiologist who has been caring for people with AFib for more than 17 years. I graduated from Northwestern University Medical School as part of the Honors Program in Medical Education (HPME), and did my internship, residency, chief residency, cardiology fellowship, and electrophysiology fellowship at Stanford University Medical Center.
My Book: Restart Your Heart
Restart Your Heart is a book that I wrote to help individuals and their caregivers make informed, science-backed decisions about how to live the best life possible with AFib. Learn about the latest in AFib research and treatments, presented with a holistic and integrative health approach. Topics include trigger and risk factor management, building a resilience toolbox, and a range of advanced diagnostics and therapies. Read first-hand about the experiences of people like you who took back control of their health and overcame AFib.
As mentioned above, living your best life with atrial fibrillation starts with awareness and education. In fact, there are twelve major points to consider when learning about AFib. These are as follows:
- There is significant misinformation about AFib. Be discerning when reading or hearing about atrial fibrillation. Oftentimes information originates from biased accounts of personal experiences. In fact, even doctors may not have the latest information about AFib treatment because it is such a rapidly evolving field of study.
- AFib can affect anyone. There are standard risk factors associated with AFib. We are learning more about the genetic component as well. That being said, age is the number one risk factor, so no one is immune. One in four people over age 40 will develop AFib at some point in life.
- AFib is an individual disease. experience of having AFib can, and does, vary from person to person. This variation includes symptoms, diagnosis, and treatment.
- There are multiple treatments available. We’ve come a long way in our understanding of how to treat AFib, and treatments may differ depending on the age of the patient, the type of AFib, and accompanying comorbidities.
- AFib is like an electrical cancer. Like cancer, AFib is a progressive disease. And as it progresses, the success rates of any intervention diminish. Therefore, early detection and early intervention are essential.
- The best treatment options are whole-body. All risk factors and triggers for AFib need to be addressed in addition to formal treatment methods.
- The brain-heart connection is key. The autonomic nervous system connects the brain and heart, and it must be balanced for effective treatment. Research now shows that activation of the sympathetic and parasympathetic nervous systems is involved in both triggering cardiac arrhythmias and treating them.
- Medical therapy has not progressed for decades. While we’ve learned a lot since AFib was first discovered, we are still limited by a lack of significant advancements in drug treatments. Part of this is due to the complexity of the disease and variation from individual to individual. The available medications have many side effects and toxicities.
- Ablation today is more successful and less risky than ever before. Due to a better understanding of the disease and advancements in technology, catheter ablation of atrial fibrillation can be highly successful in a properly selected patient. This is why it is critical to be evaluated by a cardiac electrophysiologist.
- AFib treatment is multi-disciplinary. To have the greatest success in managing AFib, all triggers and risk factors need to be identified and managed. There is an emerging movement to have AFib “clinics” where a patient is evaluated in one visit by a team of healthcare providers including a primary care physician, dietician, endocrinologist, and sleep medicine specialist (for sleep apnea). Your family and social support network are an important part of the team as well, helping to hold you accountable with your treatment plan.
- Treatment success looks different for everyone. For some, it may mean being cured of AFib. For others, it may mean a reduction in the number of episodes to improve quality of life. And for some, it may mean living in AFib with protection against stroke and heart failure.
- Widespread education is critical. Spreading awareness with up-to-date and credible information about AFib and its causes is necessary to help people make informed decisions about their health.
How to Deal with AFib
The first step upon experiencing irregular heartbeats is to immediately meet with an electrophysiologist. Below, we’ll be sharing more about what you need to know about life with AFib, including risk factors, making the most of doctors’ visits, and finding the right treatments. Topics will include:
- Who gets AFib and why they get it
- Risk factors
- Treatments
- AFib prevention
GETTING AN AFIB DIAGNOSIS
How Do You Know if You Have AFib?
Experiencing AFib symptoms is an obvious first sign that you should seek professional help. However, not all individuals will experience symptoms associated with the heart like chest discomfort, shortness of breath, palpitations, or lightheadedness.
One of the initial arrhythmia symptoms you may notice is a decrease in your physical performance including a feeling of low energy. Many people do not realize that AFib is the cause until after restoring normal sinus rhythm. This is partly due to accommodation to the symptoms. This is similar to someone with knee arthritis limiting their physical activity. In this analogy, when the knee is replaced or treated, a whole new world opens.
The earlier AFib is treated the better. Make an appointment with a specialist if you regularly feel fatigue, heart palpitations, or shortness of breath. Other AFib symptoms include discomfort in the chest and an overly fast heart rate.
What is an AFib Episode, and Do All People Experience Them?
An AFib episode will feel like a fluttering in your chest, or it may present as a rapid heart rate. Not all people experience these episodes, however, and AFib can be asymptomatic.
Among those who experience AFib episodes, some may experience them frequently while others experience them only intermittently. The key to detecting AFib early is to meet regularly with your primary care physician, who will be able to check for irregularities in your heartbeat. If irregularities are detected, you will receive an EKG or ECG (electrocardiogram), which are quick and easy tests that measure your heart rhythm.
RISK FACTORS AND TRIGGERS FOR ATRIAL FIBRILLATION
There are many potential AFib risk factors to be aware of, though none on their own are a guarantee that AFib will occur. We say that each case of AFib represents a perfect storm of triggers and conditions that are unique to an individual patient. And in most cases, AFib can be traced to a combination of both nature (genetics) and nurture (environment and risk factors).
Risk factors include:
- Age over 65
- Obesity
- High blood pressure
- Diabetes
- Pre-existing heart disease (coronary artery disease, valvular heart disease, congestive heart failure)
- Prior stroke
- Sleep apnea
- Thyroid disease
- High endurance athleticism (low resting heart rate)
- Family history of AFib
High Profile People with AFib
AFib can happen to anyone, including well-known politicians, actors, and athletes. These include:
- Barry Manilow
- Billie Jean King
- Larry Byrd
- Howie Mandel
- Gene Simmons
- Joe Biden
- George H.W. Bush
TREATMENT FOR AFIB
To understand how AFib is treated, we like to use the analogy of how a fire is created. To make a fire, an igniting source like a match and material like dry wood is needed. With this in mind, AFib is the fire. Triggers like alcohol, electrolyte deficiencies, sleep apnea, dehydration, and emotional stress are the matches. Risk factors like obesity, diabetes, high blood pressure, and thyroid disease are the wood. The fire occurs when matches meet the wood, and treatment is about putting out the fire or containing it in a safe manner.
Drug therapy can help contain the fire, though in 50% to 60% of cases the containment doesn’t hold.
Catheter Ablation is a minimally invasive technique whereby the AFib circuits are eliminated by radiofrequency or cryoenergy. In people with paroxysmal atrial fibrillation (in/out episodes), the fire can be extinguished in up to 90% of cases. For persistent AFib (continuous episode), the success rate is 70-80% but increases with a second procedure.
So, Can AFib be Cured?
AFib presents in three distinct stages: paroxysmal, persistent, and permanent. In many cases, it can be cured when discovered at an early stage. One of the most effective cures is heating or freezing of the heart’s electrical pathways, which offers an 85% to 90% success rate for AFib in the paroxysmal stage. With ablation, some patients can be completely cured. However, keep in mind that AFib is a very individualized disease, and the experience—and the possibility for a cure—are different from person to person.
“The most important thing about AFib is knowing that no two people have the same disease, many treatment options are available, and treatment must be tailored to the patient.” – Dr. Aseem Desai, Restart Your Heart
PREVENTING AFIB
If you do not have AFib, there are many things you can do to help prevent it. Since age is a top risk factor, we have little control over that cause for AFib. Preventing AFib comes down to maintaining a healthy lifestyle, which will reduce your risk factors and make it less likely that you’ll achieve the “perfect storm” of conditions that we talked about earlier.
Some ways to reduce your risk of AFib include:
- Controlling your blood pressure
- Managing diabetes
- Losing and/or staying at a healthy weight
- Moderating your alcohol intake
- Not smoking
- Eating a heart-healthy diet
- Practicing stress management and mindfulness
Talk to your doctor about any underlying health conditions you have that may serve as risk factors for AFib. If you do have a chronic condition that could be a trigger, make steps for efficient management and be sure to stay up to date with your treatment as needed.
WHAT TO LOOK OUT FOR
Simple devices and techniques can be a major help in identifying and diagnosing AFib in its earliest stages when it is most curable. Visit with your doctor right away if you are experiencing an irregular or rapid heartbeat, shortness of breath, chest pains, or fatigue.
Some technologies, including Apple Watch and Kardia Mobile, can also help monitor the condition of your heart and cue you into any troubling trends in heart rate or rhythm. If you have any risk factors for AFib, consider investing in a tool that will help monitor your heart on a day-to-day basis.
RESOURCES
The more information you have, the better. We invite you to browse our website, media page, and blog for the most current information on atrial fibrillation. Other helpful resources include:
Inner Workings of the Heart’s Electrical System
For individualized guidance, please contact Dr. Desai for more information. Dr. Desai is also available for speaking engagements.
We encourage you to use all of the resources available to you, including Dr. Desai’s celebrated book, Restart Your Heart. Dealing with AFib can be a scary experience, but you don’t have to do it alone.
And of course, don’t forget the twelve most important things to know about AFib:
- There is significant misinformation about AFib. Be discerning when reading or hearing about atrial fibrillation. Oftentimes information originates from biased accounts of personal experiences. In fact, even doctors may not have the latest information about AFib treatment because it is such a rapidly evolving field of study.
- AFib can affect anyone. There are standard risk factors associated with AFib. We are learning more about the genetic component as well. That being said, age is the number one risk factor, so no one is immune. One in four people over age 40 will develop AFib at some point in life.
- AFib is an individual disease. The experience of having AFib can, and does, vary from person to person. This variation includes symptoms, diagnosis, and treatment.
- There are multiple treatments available. We’ve come a long way in our understanding of how to treat AFib, and treatments may differ depending on the age of the patient, the type of AFib, and accompanying comorbidities.
- AFib is like an electrical cancer. Like cancer, AFib is a progressive disease. And as it progresses, the success rates of any intervention diminish. Therefore, early detection and early intervention are essential.
- The best treatment options are whole-body. All risk factors and triggers for AFib need to be addressed in addition to formal treatment methods.
- The brain-heart connection is key. The autonomic nervous system connects the brain and heart, and it must be balanced for effective treatment. Research now shows that activation of the sympathetic and parasympathetic nervous systems is involved in both triggering cardiac arrhythmias and treating them.
- Medical therapy has not progressed for decades. While we’ve learned a lot since AFib was first discovered, we are still limited by a lack of significant advancements in drug treatments. Part of this is due to the complexity of the disease and variation from individual to individual. The available medications have many side effects and toxicities.
- Ablation today is more successful and less risky than ever before. Due to a better understanding of the disease and advancements in technology, catheter ablation of atrial fibrillation can be highly successful in a properly selected patient. This is why it is critical to be evaluated by a cardiac electrophysiologist.
- AFib treatment is multi-disciplinary. To have the greatest success in managing AFib, all triggers and risk factors need to be identified and managed. There is an emerging movement to have AFib “clinics” where a patient is evaluated in one visit by a team of healthcare providers including a primary care physician, dietician, endocrinologist, and sleep medicine specialist (for sleep apnea). Your family and social support network are an important part of the team as well, helping to hold you accountable with your treatment plan.
- Treatment success looks different for everyone. For some, it may mean being cured of AFib. For others, it may mean a reduction in the number of episodes to improve quality of life. And for some, it may mean living in AFib with protection against stroke and heart failure.
- Widespread education is critical. Spreading awareness with up-to-date and credible information about AFib and its causes is necessary to help people make informed decisions about their health.
Purchase Restart Your Heart today to learn everything that you know about improving your quality of life with AFib. There are many options available for treating and preventing atrial fibrillation, and the earlier you begin, the better.
Want to hear what Dr. Desai has to say in person? Schedule a speaking engagement.
