A-fibbing
Losing the beat
A-fib is a common condition that causes a faster or irregular heartbeat. It is rare under 50, but 1 in 9 80-year-olds has it. A-fib is short for atrial fibrillation. It means the heart’s top two chambers (the atria) are beating out of sync with the bottom two (the ventricles).
4 Chambers
Of the 4 chambers of the heart, the top 2, the atria, are smaller because they pump the blood into the larger main chambers, the ventricles. The ventricles are larger as they push blood out of the heart into the body. Blood enters the heart in the right atrium and goes from there to the right ventricle. The right ventricle pushes blood through the lungs. The left atrium takes in oxygen-rich blood from the lungs and moves it to the left ventricle. The left ventricle pushes it through the whole body. That is why the left ventricle is the strongest part of the heart. If the chambers get out of sync with one another, less blood flows through the lungs and body.
Heartbeat
The heartbeat sound comes from the closing of the heart valves. The valves in the heart make sure blood only flows in one direction. The 2 internal valves of the heart (the tricuspid and bicuspid or mitral valve) cause the first beat, and the 2 outgoing valves (the pulmonary and aortic valves) make the second sound. The da-dump of your heartbeat is the 4 valves closing.
Electrical system
The heart has its own electrical system. The heart muscles contract or beat when they get an electrical signal from the heart’s pacemaker. The heart’s pacemaker (the SA node) coordinates all the contractions, so they are in sync. In A-fib, the atria, the smaller, top chambers, start generating their own signals that are rapid and out of sync.
Silent fibbing
Often, a person can’t tell they are in A-fib. Thankfully, A-fib is not usually life-threatening. A-fib tends to reduce the amount of blood pumped by about 10% to 20%. If you are exerting yourself and have little margin, A-fib may cause shortness of breath.
Intermittent A-fib
Often, A-fib comes and goes. This type of A-fib is hard to detect. The heart will develop an irregular heartbeat but then, on its own, restore a regular beat. Generally, these short episodes are not an immediate threat, but they can raise the risk of stroke due to the potential to create clots.
Long-term A-fib
Sometimes your heart can go into A-fib for days at a time. A-Fib that lasts for days can become dangerous, especially when the heart rate is over 100.
When it happens
A-fib can occur with no cause, or it can be an indicator of an underlying heart condition. In either case, make sure to get it checked out. Any kind of reoccurring A-fib increases your risk of stroke.
Risks
Age is the biggest risk factor for A-fib and not one you can control. The other biggest risk factors are diabetes and high blood pressure. Both increase the risk of A-fib by 50%. Having any kind of pre-existing heart disease also increases the risk of A-fib a lot. But typically, if you already have a known heart condition, your doctor will monitor you for A-fib.
Alcohol
Alcohol is also linked to A-fib. Any more than one drink a day increases your risk of having A-fib. If you have more than 3 drinks a day, the chance of A-fib is even higher. And there is some evidence that people with existing A-fib are more likely to get an episode if they drink alcohol. Drinking more than 5 drinks at a time is a known trigger for A-fib. Alcohol seems to interfere with the natural beat mechanism of the heart, so if you have or are at risk of A-fib, limit alcohol.
Clot risk
The big risk of A-fib is it can cause blood clots. These blood clots can then go on to cause a stroke. About 1 in 7 strokes are related to A-fib. A-fib increases the risk of stroke by 4 to 5 times. And also, strokes related to A-fib tend to be worse.
Reset treatments
A-fib can be treated in several ways. Sometimes, the heart needs a simple reset. This shocks it into setting the normal rhythm, and often the A-fib doesn’t return.
Surgical treatment
In some cases, A-fib is best treated with surgery. The surgery involves placing a device into a vein to the heart and then creating small scars on the heart to block the abnormal electrical signal. These small scars can prevent the ‘short circuits’ that cause A-fib. Any surgery has risks, and it doesn’t always work. Be sure to look at all the options.
Blood thinners
With A-fib, blood thinners are often recommended as they can help prevent strokes. Strokes occur when a blood clot makes its way to the brain. Blood thinners reduce the risk of stroke.
Heartbeat drugs
Medications can also control A-fib over a longer term. Some drugs that can slow the heartbeat are sometimes used for A-fib. Beta-blockers or calcium channel blockers can reduce the amount of A-fib. Like all medications, they have side effects, but there are risks if you do nothing for your A-fib. Get the information and weigh the trade-offs with your health care provider.
Prevention
As you get older, especially if you have additional risk factors for A-fib, such as high blood pressure or diabetes, consider getting a home EKG system to monitor yourself. One-third of people with A-fib don’t even know it. For under $200, you can buy a good home EKG, like the AliveCor KardiaMobile 6L. If you have intermittent A-fib, it could help by providing some great information for your doctor.
Smartwatch
Another option is an Apple Watch or Samsung Galaxy Smartwatch. These smartwatches also do EKGs and warn you if you are currently in A-fib. They have the added advantage of tracking a lot of other health-related information, including tracking your exercise. The downside is they are expensive. The Apple Watch, for instance, is $500!
A-Fib emergency
Although A-fib can be silent, you will often feel a bit strange. If you don’t feel like yourself, check your pulse or use your home EKG if you have one. If your heart is frequently over 120 beats per minute, or if it has lasted more than a day, or if you are having chest pain, stay calm and get to the hospital. Don’t take a chance.
A-Fib plan
The reality is that every decade we get older, our risk of A-fib doubles. The best way to manage the risk is very similar to managing all heart health. Eat healthy, exercise regularly, sleep well, and monitor your mental health. Even if you do everything right, you may still get it, but treatments can help. The most important thing is to take charge of your health and make a plan with your healthcare provider.
