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Health Matters 10/11: Understanding and treating Atrial Fibrillation (A Fib)

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By Lisa S. Motavalli, M.D.

A fluttering in your chest, racing heartbeat and shortness of breath can all be signs of being overly excited.

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But they can also be indications of atrial fibrillation or A fib, a common but serious heart condition that requires medical attention.

If you have symptoms of A fib, see your doctor for an evaluation. Left untreated, this condition can greatly increase the risk for blood clots, stroke and heart failure.

What is A Fib?

An arrhythmia is when the heart beats too slowly, too fast, or in an irregular way. Atrial fibrillation is an arrhythmia in which the two upper chambers of the heart beat irregularly. According to the American Heart Association, at least 2.7 million Americans are living with A fib.

An abnormal heartbeat that’s too fast can eventually lead to heart failure. A change in heart rhythm can also increase the risk of blood clots. Clots are dangerous because they can break off and travel to the brain, causing a stroke. In fact, A fib is associated with a five-fold increased risk for stroke, according to the American Heart Association.

Are You at Risk?

Certain factors can increase the risk for developing the condition, including:

  • Advancing age
  • Heart disease
  • High blood pressure
  • Underlying chronic diseases such as diabetes, sleep apnea, thyroid disorder, lung conditions
  • Use of alcohol
  • Obesity
  • Family history

What Are the Signs?

Some people who have A fib don’t have any symptoms and don’t know they have it until it’s discovered during an unrelated medical visit. Others may experience the following:

  • Irregular heartbeat
  • Heart palpitations (rapid, fluttering or pounding)
  • Lightheadedness
  • Extreme fatigue
  • Shortness of breath
  • Chest pain

A fib can occur in brief episodes or can be a permanent condition. If you experience symptoms of A fib, see your doctor right away for diagnosis and treatment.

How is A Fib Diagnosed and Treated?

A diagnosis of A fib can be made with an electrocardiogram or with heart rhythm monitoring. Treatment depends on your overall health, medical history, lifestyle and symptoms.

Often, treatment begins with blood-thinning medication to help reduce the risk of blood clots and stroke. Medicines may be needed to control the rate or rhythm of the heartbeat.

In some cases, the heart rhythm may be reset with a brief procedure called electrical cardioversion, in which an electric shock is delivered to the heart to reset it. Maintaining a normal heart rhythm after electrical cardioversion may require medication to help prevent future episodes of A fib.

Other procedures to treat A fib may include catheter ablation, in which a catheter (thin tube) is inserted through the veins and into the heart and is used to reestablish and maintain a normal heart rhythm.

Can A Fib Be Prevented?

Not all cases of A fib can be prevented. But it is important to live a heart-healthy lifestyle to reduce your overall risk of heart disease and to help avoid conditions that may put you at risk for A fib. This includes:

  • Eat a healthy diet. Include plenty of fresh fruit, vegetables and whole grains. Limit saturated fat and foods high in sodium and added sugars.
  • Exercise regularly. The American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise or a combination of the two. However, if you can’t achieve those goals, any amount of movement is better for your health than being sedentary. See your doctor before starting a new exercise program.
  • Maintain a healthy weight. Eating a healthy diet and exercising regularly can help you maintain a healthy weight.
  • Don’t smoke. Cigarette smoking raises your blood pressure and can increase your risk for heart disease.
  • Limit alcohol. Drinking too much alcohol can also raise your blood pressure and the extra calories can contribute to weight gain.
  • Manage high cholesterol, high blood pressure, diabetes and other chronic health conditions. See your doctor on a regular basis and be sure to get your blood pressure and cholesterol levels checked. It is important to have regular medical care to ensure health conditions are under control.
  • Manage stress. Excessive stress can lead to unhealthy habits that are associated with heart disease, such as eating poorly, smoking, drinking too much alcohol and not exercising.

To find a physician with Penn Medicine Princeton Health call 888-742-7496 or visit www.princetonhcs.org.

Lisa S. Motavalli, M.D., is board certified in cardiovascular disease and internal medicine and is a fellow of the American College of Cardiology. She is a member of the medical staff at Penn Medicine Princeton Health.

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