A sudden change to your regular heartbeat can be frightening and unexpected. However, it’s not uncommon. About 10.5 million Americans experience atrial fibrillation (AFib), a heart condition that causes an irregular and rapid heartbeat in the upper chambers of the heart, at least once in their lives, if not regularly.
Sometimes when you experience a sensation causing your chest to tighten, you may fear you’re having a panic attack or possibly even a heart attack. But one of the most common reasons for an irregular heartbeat or palpitations is AFib, says Dr. Kevin Rabii, DO, cardiologist at Memorial Hermann Medical Group (MHMG) Memorial City Cardiology.
“AFib can come and go,” Dr. Rabii says. “Some people may have a couple of episodes a year, while others may have it persistently.”
Fortunately, the condition is manageable and treatable, he says.
Dr. Rabii discusses tips for living with AFib:
What’s Going On?
Atrial fibrillation earns its name in part from where it occurs: the top two chambers of the heart, known as the atria.
Normally, nerve endings in a node within the heart send synchronized and efficient electrical pulses to these upper chambers of the heart. That causes the heart muscle to contract, which in turn propels blood through the heart and out to the body.
“Our heart is a muscle, and what tells the muscle to contract is an electrical signal,” Dr. Rabii says.
But when the electrical beat goes haywire, so do the contractions. Rather than being regular and complete, “they’re almost like convulsions,” he says.
Such irregularities are known as fibrillation.
Why Does It Matter?
Untreated AFib doubles your risk of heart-related death and increases the risk of stroke, reports the American Stroke Association.
One reason is that heart problems often accompany each other. “You’re more likely to have AFib if you also have high blood pressure, heart failure or heart disease,” Dr. Rabii says. “There’s also a strong link to sleep apnea.”
Sleep apnea can block airflow toward the rear of the throat, causing a person to gasp for breath, wake up repeatedly and snore loudly. Such stop-and-start breathing can cause a drop in the blood’s oxygen, which then can spur an increased heart rate and high blood pressure.
AFib’s insufficient heart contractions also can cause blood to pool in the heart, making clots more likely to form.
How Do You Know You Have AFib?
Like high blood pressure, AFib may be sporadic, or it may be constant—and you could be unaware that you have it.
But AFib can have symptoms to alert you to its presence. These include:
- Shortness of breath
- Dizziness
- Fatigue
- Pounding or fluttering heartbeat
- Chest pain
If these symptoms prompt a visit to your health care provider, your doctor can identify AFib by using a stethoscope or an electrocardiogram (ECG/EKG), the latter of which records your heart’s electrical activity.
Your doctor then may ask you to wear a heart monitor for several days to monitor your heart rhythm outside of the clinic.
What Can You Do About AFib?
While you can’t alter your age or your genes, you can change your lifestyle to improve your heart health, Dr. Rabii says. “Physical activity and maintaining a normal body weight are extremely important.”
To lower your risk of AFib, try doing the following:
- Eat a diet rich in vegetables and fruits and low in prepackaged foods.
- Control portions.
- Keep your blood pressure in a healthy range.
- Minimize your alcohol, ideally to a few drinks weekly.
- Quit smoking.
- Get moving, exercising at least 50 minutes for three to five days each week.
- Maintain a sleep schedule and treat apnea if you have it. Your primary care physician may be able to guide you. If that’s insufficient, a sleep specialist can help.
- Make this a family affair. Starting young can help your kids make heart-healthy moves a lifelong habit.
All of these measures combined can help you to lose weight, which reduces AFib’s symptoms and progression.
If you’re doing everything you can yet still have an irregular heartbeat, your doctor may prescribe medicine to control your heart’s rhythm, along with blood thinners to thwart blood clots.
What About Hospital Treatments?
If medication does not treat symptoms, two in-hospital procedures can help.
One treatment is a cardioversion, “which is a way we can reset the heart’s rhythm,” Dr. Rabii says. “Typically, it's the first thing we do if AFib isn’t going away.”
“Once the patient is sedated, we deliver an electrical impulse that resets the rhythm of the heart. Essentially, it’s like a jump-start for a car. Usually, the patient can go home in a couple of hours.”
The other treatment is ablation, a long-term solution by which heart tissues where the AFib originates are burned or frozen, thus forming a fence around abnormal tissues and their erratic firing of nerves. The procedure is performed in a hospital by an electrophysiologist, a doctor who specializes in the heart’s electrical system.
“However you do it, the important thing is that AFib can be treated and managed,” Dr. Rabii says. “You still can live a full and healthy life.”
