Atrial fibrillation—what it is and what to do
THE MOST COMMON kind of heart-rhythm abnormality, atrial fibrillation (AFib) affects about six percent of people over 65. It happens when the atria—the heart’s two upper chambers—contract quickly and chaotically. Whereas a normal resting heart rate ranges between 60 and 100 beats per minute, a resting heart affected by AFib may at times beat between 100 and 175 times within the same time period.
As scary as this sounds, many people with AFib feel fine. They may not know about their condition until a doctor notices an unusual heartbeat during a checkup. However, if there are clear symptoms, they could include chest pain or thumping, shortness of breath, light-headedness or anxiety. (Chest pain or pressure could also indicate a heart attack, so if you experience either of those, you should play it safe and head to a hospital.)
Different things can contribute to the development of AFib, including thyroid problems, high blood pressure, sleep apnea, binge drinking or heart disease—anything that could
stretch or scar the atrial walls. It is more common among seniors and people with a family history of the condition. Once you’ve been diagnosed, your doctor will likely recommend blood thinners to help prevent strokes and blood clots.
For many patients, AFib progresses from occasional episodes to longer, more frequent ones, “like a car that needs to go to the garage for the same problem increasingly often,” says Dr. Dan Atar, a co-author of the European Society of Cardiology’s AFib treatment guidelines. For as long as it persists, you’ll likely need rate-control drugs, which slow the heart’s racing; you can also take antiarrhythmic medications, which control abnormal heart rhythms, preventing new episodes.
Your doctor may be able to reset your heart from an AFib episode using drugs or a slight electric shock. Your best shot at putting an end to recurring episodes is catheter ablation, which involves sending a catheter into the heart to burn the tissues that are firing off irregular impulses. Ablation works about 70 to 75 percent of the time and stands a decent chance of solving the problem permanently.
AFib causes nearly 35% of all strokes in people over 60.