How To Tell If Afib Is Getting Worse
Your AFib treatment should help control your heart rate, rhythm, and prevent blood clots. If you notice that your AFib episodes happen more often, last longer, or your medication doesnât help as much, your condition is probably getting worse.
As AFib progresses, you might notice some signs. You might feel more weak, tired, lifeless, and anxious about the condition.
Treatment For Atrial Fibrillation
Our doctors use the least invasive approaches to treating AFib when possible. Depending on your symptoms and overall health, our doctors can offer you several options to treat your AFib. Our approach entails two key steps: managing your risk for stroke and restoring a normal heart rate and rhythm.
Step 1: Assessing and Managing Stroke Risk
At Stanford, every AFib care plan starts with a thorough evaluation of your risk for stroke, which is five times higher if you have atrial fibrillation. We assess and manage your stroke risk by using medications and advanced treatments including left atrial appendage closure. This procedure closes a small pouch in the heart where blood clots often form and can reduce your risk of stroke.
Step 2: Restoring Normal Heart Rhythm
AFib treatment at Stanford also focuses on restoring your normal heart rate and rhythm to alleviate common symptoms such as fatigue, shortness of breath and a racing heart. There are many options available to treat AFib. Whenever possible, we take the least invasive approach.
Medications
Your doctor may prescribe medications to slow your heart rate or to restore normal rhythm . Your doctors may tailor the medications such as anti-arrhythmic agents based on whether you have problems with your heart arteries, have impaired pumping function of the heart, or have kidney and liver abnormalities.
Lifestyle Changes
Treating related conditions
Cardiovascular And Circulatory Systems
When your hearts electrical system is out of whack, the chambers lose their rhythm. A common symptom of AFib is the sensation that your heart is flopping around inside your chest, or simply beating irregularly, causing palpitations. You may become very aware of your own heartbeat.
Over time, AFib can cause the heart to weaken and malfunction. The hearts ineffective contractions cause blood to pool in the atria. This can increase the risk of clotting.
As a result, you may experience:
- shortness of breath
- low blood pressure
- chest pain
During an episode of AFib, your pulse may feel like its racing, beating too slowly, or beating irregularly.
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Can Strenuous Exercise Trigger Afib
The next thing that can trigger episodes of atrial fibrillation is exercise. There may be patients out there who clearly see that a certain type of exercise triggers atrial fibrillation. The tricky part about exercise induced atrial fibrillation is that exercise is actually healthy for you. In general, it is recommended that if you have atrial fibrillation that you should exercise, you should try to lose weight if overweight, and so exercise is always good. But exercise should be carefully monitored if you have atrial fibrillation. People with atrial fibrillation need to be careful when exercising to try to figure out where your own individual tolerances are. Usually I recommend to my patients to start off slow with things that are low-impact, and build up, as you are able to.
Also, heart rate monitors, whether that’s a Fitbit or Apple watch, have been very useful for patients to monitor their exercise. They can be used to monitor your heart rate to help try to prevent episodes of atrial fibrillation while exercising. Of course while exercising staying hydrated is an important tip as well.
How Does It Feel To Have Atrial Fibrillation
How atrial fibrillation feels varies from person to person. Some patients notice palpitations and irregular heartbeats and are immediately aware when atrial fibrillation starts. Others feel chest discomfort, shortness of breath, lightheadness, dizziness or a general tiredness, without having palpitations. In some individuals symptoms of atrial fibrillation can be present at rest, while in others they appear during exercise.
The onset of an episode of atrial fibrillation is not always clear. In some cases symptoms start abruptly while in others there is a reduction in the ability to exercise. In the latter case one may not suspect atrial fibrillation and it can take a long time before the patient seeks medical attention.
Finally, it is possible that someone with atrial fibrillation has no symptoms at all and the arrhythmia is discovered accidentally, for instance during a routine check-up or using wearables.
The reason why some people with atrial fibrillation experience symptoms, while others do not, is unclear. In many patients the symptoms are related to a faster heartbeat. However some patients have symptoms, even if the heart rate is not fast. In other cases the heart beats too slowly during atrial fibrillation which can also cause symptoms.
The content for this website for patients has been reviewed by Dr. Heather Edwards ).
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Restoring A Normal Heart Rhythm
There are a number of drugs that can be used to try to restore a normal heart. The best option for you will be decided by your cardiologist and /or GP.
Commonly, these drugs include:
- amiodarone
Dronedarone may also be used for certain people.
It is important you know what side effects to look out for if taking such medication and seek medical advice if you experience any of them.
To find out about side effects, read the patient information leaflet that comes with your medicine for more details.
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A Team Effort From The Local Leader
For cases such as Petes that require treatment more extensive than medication such as blood thinners, TriHealth offers a hybrid mini maze treatment, a newer strategy that involves collaboration between a surgeon and an electrophysiologist. TriHealth is the only provider performing this hybrid treatment in Cincinnati and one of only about 50 nationwide.
The first part of Petes treatment was a minimally invasive maze procedure performed early in 2015 by Dr. Okum at Bethesda North. A mini maze uses heat to create a pattern of scarring along the left atrium to create a disturbance that corrects the irregular heartbeat. Because the procedure is performed thoracoscopically and is minimally invasive, there is less pain, less risk of infection and easier recovery than through open heart surgery. It involves eight minor incisions with four on each side and usually requires a hospital stay of only three to four days.
This procedure makes a patient feel better, even those who are asymptomatic, Dr. Okum says. No matter how they felt when we started, when they get out they feel better.
This was certainly the case for Pete. I felt amazingly different, he says about his own immediate recovery time. I woke up sore, but I actually felt good for the first time in a while
Petes ablation also was performed at Bethesda North by Dr. Gandhi, who credits TriHealths team approach with providing a success rate of greater than 85 percent for patients like Pete.
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What Is Atrial Fibrillation
Atrial fibrillation is a medical disorder that affects the upper chambers of the heart, known as the atrias. People with AFib experience irregular heartbeats caused by abnormal electrical signals in the atria.
The electrical impulses erroneously circulate through the atria, causing the atria to contract with an irregular rhythm and fast rate. Different areas of your heart may beat too quickly, too slowly, or in an uneven rhythm in response to the AFib.
When the lower chambers of the heart, known as ventricles, beat too quickly during AFib, this is known as AFib with a rapid ventricular response.
Paroxysmal AFib is the name for AFib that happens occasionally and usually stops on its own. These transient episodes are usually brought on by a specific trigger. Recognizing triggers and avoiding them can help you manage AFib effectively.
Some of the most common triggers include
- hormones
are at a greater risk of developing AFib. This is due to a few reasons, including the prevalence of visceral fat surrounding the muscle layer of the heart.
The condition of obesity can also increase inflammation both around the heart and in the rest of the body. It can contribute to the development of certain chronic conditions, such as type 2 diabetes and heart disease.
Common Triggers For Afib
What can cause an individual episode of atrial fibrillation? In a previous post, I discussed what are the most common causes of the long-term condition of atrial fibrillation, but in this segment, I will discuss things that can actually exacerbate or trigger an episode of atrial fibrillation.
Now, some of these triggers don’t apply to everyone. Figuring out which triggers affect your atrial fibrillation means you needing to be a detective about your own atrial fibrillation to know what more commonly triggers your atrial fibrillation, so you know better what to avoid.
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The Hearts Normal Electrical Pattern:
- The current travels from top to bottom. The heartbeat starts at the top of the heart and like an electrical wave the current travels to the lower parts of the heart, signaling the tissue to contract.
- The sinoatrial node starts the contraction in the top of the heart. The right atrium houses a group of cells called the sinoatrial node. In healthy adults, the SA node fires off between 60-100 heartbeats per minute. The electrical wave moves through the atria to gatekeeper node.
- The atrioventricular node regulates the timing for the lower portion of the heart. The AV node serves as a gatekeeper for all of the electrical pulses going through the atria to the ventricles . The electrical pulses are delayed at the AV node before they are allowed to move into the ventricles. The delay gives the ventricles extra time to finish filling with blood before contracting.
- The ventricles contract and pump blood out to the lungs and the body.
Tailor The Treatment Plan To Your Needs
If youve recently been diagnosed with the condition, odds are, youve also started taking medications. They are a practical solution for controlling the triggers. But, what most people dont realize is that the dose will have to change after some time.
If you are taking beta-blockers, you might start to feel a little sluggish. Thats because these meds are known for causing exhaustion. If the tiredness becomes too overbearing, you should consult with your doctor. They will either change the dose or suggest a completely different medication.
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Can You Prevent Complications
A few healthy habits can help you avoid the other health problems that AFib can cause.
- Eat a heart- and brain-healthy diet. Limit salt, and saturated and trans fats. Make fruits, vegetables, whole grains, and lean protein the majority of your diet.
- Exercise on most days of the week. Ask your doctor to recommend a fitness plan that’s safe for your heart.
- Manage blood pressure and cholesterol with diet, exercise, and medicine if you need it.
- If you smoke, ask your doctor for advice on how to quit.
Show Sources
American College of Cardiology: “Patients with AFib Can Prevent Heart Failure with a Few Key Choices,â âHAS-BLED Tool — What is the Real Risk of Bleeding in Anticoagulation?â
Clinical Interventions in Aging: âCHADS2 score has a better predictive value than CHA2DS2-VASc score in elderly patients with atrial fibrillation.â
American Heart Association/American Stroke Association: “When the Beat is Off – Atrial Fibrillation.”
American Heart Association: “Atrial Fibrillation Medications,” “Prevention Strategies for Atrial Fibrillation ,” “When the Beat is Off — Atrial Fibrillation,” “High Blood Pressure, Afib and Your Risk of Stroke,” “What is Atrial Fibrillation ?”
Cleveland Clinic: “Atrial Fibrillation : Management and Treatment.”
European Cardiology: “Atrial fibrillation, cognitive decline and dementia.”
Heart Rhythm Society: “Complications from Atrial Fibrillation.”
Mayo Clinic Health Letter: âCHADS2 score.â
Heart Foundation: âAspirin.â
Black Americans And Atrial Fibrillation
The risk for atrial fibrillation is higher in Americans of European descent than in African Americans, according to the Centers for Disease Control and Prevention .
In a study published in July 201 in JAMA Cardiology, researchers tracked more than 15,000 participants over decades and found that the risk of afib was 8.1 per 1,000 person-years for white participants, and only 5.8 per 1,000 person-years for Black participants. But among Black participants who did develop afib, there was a higher risk of stroke, heart failure, and death.
In another study of the same participants, published in July 2018 in Circulation: Arrhythmia and Electrophysiology, researchers found that the lifetime risk for afib was 36 percent for white men, 30 percent for white women, 21 percent for African American men, and 22 percent for African American women.
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Can It Be Prevented
Srivatsa: Like most heart disease, AFib is often preventable with healthy lifestyle practices. Limiting alcohol consumption, maintaining a healthy weight, eating a heart-healthy diet and exercising every day, and regular meditation have been shown to reduce the likelihood of AFib or help alleviate symptoms once it is diagnosed.
About Heart Rhythm Consultants Pa
The experienced electrophysiologists of Heart Rhythm Consultants, P.A. have been serving West Florida including Sarasota, Venice, Tampa, Port Charlotte, and Sun City Center for over 15 years. Our specialty cardiologists, or EP doctors, help patients manage their abnormal heart rhythm conditions, whether they suffer from arrhythmias like atrial fibrillation , or other irregular heartbeats. Dr. Dilip J. Mathew, Dr. Antonio Moretta, and Dr. Rajesh Malik perform arrhythmia treatments like cardiac ablation, cryoablation, and implanting pacemakers or defibrillators. Dr. Mathew has performed nearly 5,000 complex cardiac ablations. View our office locations in Sarasota and Venice, Florida.
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How Do You Stop An Afib Episode
There are many ways that people manage their atrial fibrillation at home including many of my own patients. There are up to 4 methods that I frequently discuss with my patients, which can include vagal maneuvers and biofeedback just to name a few. but it is also important to know when is the right time to seek emergency treatment for AFib. Check out my article for tips for managing atrial fibrillation attacks at home here.
View An Animation About Atrial Fibrillation
AF Patient Animation –
*This is one clinician’s experience. Results may vary.
If left untreated, AF as a disease continues to progress. There are three types of AF:
- Persistent AF will last for more than seven days and will not correct on its own
- Permanent AF is a consistently high, erratic heartbeat that cannot be corrected
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A Team Approach To Afib Care
Certain heart conditions, including coronary artery disease and heart valve problems, increase your risk of Afib. And if you have Afib, you have a higher risk of conditions such as heart failure.
To help make sure you get complete cardiovascular care, our electrophysiologists work closely with many other UI Heart and Vascular Center experts. This includes providers who specialize in:
Together well provide the care and support you need to improve your Afib symptoms and overall heart health.
Foods To Eat And Foods To Avoid
When you’ve been diagnosed with AF, the best kind of eating programme to follow is a heart healthy eating plan. The plan will help you manage your atrial fibrillation symptoms and reduce your risk of other types of heart disease.
A heart healthy diet means eating a dietary pattern based largely on minimally-processed foods with plenty of vegetables and fruit. Include some intact whole grains in place of refined grains: legumes, nuts, seeds and other sources of healthy fats such as oily fish. You can also include non-processed lean meats or poultry and/or dairy.
The diet also means cutting back on foods that are high in saturated fats and trans fats, salt and sugar. You’ll find more about how to follow a heart healthy eating pattern on our nutrition pages.
There are also some foods you’ll need to avoid if you’re taking certain medications. If you’re on warfarin you’ll need to make sure you don’t eat large quantities of vitamin K. Foods that contain high levels of vitamin K include:
- leafy green vegetables, such as spinach and kale
- cauliflower
- parsley
- green tea.
If you’re on anti-arrhythmic drugs, such as amiodarone, you’ll need to avoid grapefruit as it can make your medication less effective.
You may also need to avoid other substances that trigger AF, such as alcohol and possibly caffeine. You can read more about triggers on our managing your AF page.
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Surgical And Other Procedures
Procedures to help control afib range from noninvasive treatments to surgery, and include the following:
Electrical Cardioversion In this procedure, youre given a sedative, and an electrical shock is delivered through paddles or patches on your chest to try to reset your hearts normal rhythm.
Catheter Ablation A long, thin tube is inserted into a blood vessel and guided to your heart, where energy, heat, or extreme cold is applied to destroy heart tissue thats causing your arrythmia.
Maze Procedure Different variations of this procedure use a scalpel, radio waves, or extreme cold to create a pattern of scar tissue in the heart that helps control stray electrical signals.
Atrioventricular Node Ablation This procedure, which may be considered if other treatments dont work, destroys the pathway that connects the upper and lower heart chambers. It requires fitting a pacemaker to keep the lower chambers beating, and youll still need to take blood thinners.
Left Atrial Appendage Closure This procedure closes off a small sac in the left atrium that can contribute to blood clots forming in the area.
- Reducing or coping with stress
- Using cough and cold medications with caution
You should also make sure youre effectively treating or controlling existing health conditions that may lead to afib, such as sleep apnea, diabetes, or high blood pressure.
