If you read one thing today, make it this. I first heard about atrial fibrillation (or AFib) after my Mom had a stroke. Thankfully, she’s fine now. But when I spoke to two heart rhythm specialists with Brookwood Baptist Health, they said sadly, that’s the way most people learn of this potentially deadly, yet treatable, condition. Keep reading for the basics. The life you save might be your own—or that of someone you love.
In case you’ve never heard of a cardiac electrophysiologist (I hadn’t, even though my mom has AFib), they’re basically heart rhythm specialists. Most of us are familiar with what doctors call the “plumbing” side of heart problems such as blockages. We tend to be less familiar with the “electrical” problems of the heart.
Cardiac electrophysiologists, according to Dr. Smith, “deal with electricity—specifically with the electrical impulses in the heart that control its rhythm and trigger heartbeats. The electrophysiologist is trained to diagnose and treat arrhythmias.”
Here’s what they told me:
Atrial Fibrillation: what it is
Dr. Smith: With estimates of between 2.5 to 6 million people affected in the US alone, atrial fibrillation is the most common heart rhythm problem in the country.
In a nutshell, it works like this:
- Electrical activity in the upper left chamber of the heart makes that chamber beat too fast.
- Instead of a nice, steady beat, the upper and lower chambers get out of sync and both end up beating way too fast.
- With an irregular rhythm, the heart doesn’t get a nice, steady contraction, and isn’t able to deliver enough oxygen to the rest of the body.
- Also, there’s a little nook in the upper left chamber called the left atrial appendage. When the rhythm’s off, blood can pool and clot.
- When the heart “throws off” a clot, it can cause a stroke.
What AFib is not
Dr. Sandberg: It’s not “just an irregular heartbeat” or a “skipped beat,” which is how doctors sometimes talk about it. It’s also not a “funny irregular thing that happens sometimes.”
It’s a serious condition that, left untreated, can lead to a stroke. With a stroke, your life can be over or permanently changed.
Why it matters
If you’re having these symptoms, get checked out
Dr. Smith and Dr. Sandberg said it’s important not to ignore these symptoms:
- Fatigue and shortness of breath
- Racing, irregular heartbeat (not everyone feels this, but some do)
Need to talk with an expert about your symptoms? Reach out to Brookwood Baptist Health today.
Dr. Smith went on to explain that AFib is a progressive disease that is often misdiagnosed:
“It’s frustrating because people will have palpitations, and initially the episodes are short and infrequent. By the time the patient gets to the doctor and has an EKG, it’s resolved. Sometimes the doctor will say it was a panic attack, mitral valve prolapse or an anxiety disorder. Some patients have palpitations for years that have been missed, and it takes years for them to get the diagnosis.”
How do you get it?
Dr. Smith: Some of the risk factors are similar to other medical conditions:
- High blood pressure
- Heart disease
- Overactive thyroid
There are hundreds of genes associated with AFib, not just one. If it’s in your family, you need to watch out for it more closely. But it’s by no means one of those things where if your parents have it, you’ll have it.
Finally, as we age, everyone’s risk increases. It’s rare to see AFib in people under 40, and the majority of folks I see are in the 60 to 80-year old range. It really spikes in the 80s.
Treatment is available
Diagnosing atrial fibrillation is easier than it used to be
As with most things, the first step in treatment is an accurate diagnosis.
“There are a lot more long-term monitoring devices than we used to have. We actually have implantable monitors that can look at the heart rhythm over a three-year period. This is helpful, because AFib can be tricky. It comes and goes, and if we don’t find it, we can’t treat it,” Dr. Sandberg said.
Dr. Smith stated that there are new monitors which are basically a sticker that goes on the chest. He also said Apple watches and other wearables provide some good data.
If you suspect that you or someone you love may have atrial fibrillation, you can call a cardiac electrophysiologist’s office directly and make an appointment.
There are a number of treatment options available
According to Dr. Smith, there are two main goals for AFib treatment:
- Prevent strokes
- Suppress AFib episodes
Anticoagulation medications, commonly referred to as “blood thinners,” help reduce the chance of stroke.
Heart rhythm medications can help get the heart’s rhythm back on track.
Ablation is another way to address the heart rhythm. This is where the doctor goes in through a blood vessel in the leg, inserts a catheter in the heart, then lightly cauterizes around the overactive areas of the heart.
“My hope and dream for the future is that everyone with AFib or any other type of heart rhythm problem will be followed by a heart rhythm doctor.”
—Dr. Macy Smith