As we near Valentines day and love is in the air, there are many people getting ready for the holiday whose “skipping heart” is less about their dream date and more about an all too common irregular heart rhythm called atrial fibrillation or “afib.”
This arrhythmia sends hearts into an erratic, often rapid frenzy, and increases one’s risk for stroke. To complicate matters, some people don’t have any symptoms of atrial fibrillation until it is picked up by their physician. This arrhythmia affects nine percent of all Americans over the age of 65 and if left untreated can lead to heart failure and stroke. Thankfully we know quite a bit about atrial fibrillation including who is at risk and how to minimize its impact.
What is afib?
Afib is short for atrial fibrillation. A normal heart beat begins when the top chamber contracts followed by the bottom chamber contracting. In contrast, during atrial fibrillation, the top chamber goes into wild spasms with a million little beats all firing at once, all competing to get to the bottom chamber. This causes the bottom chamber to fire erratically and often, but not always, quite fast. The heart can eventually become weak (heart failure) if the heart rate stays elevated for too long (consider running your car engine at max RPMs for days on end, something has to give.) But because the top chambers (atria) are no longer contracting but rather in spasm (fibrillating) the blood can clot in the top chamber. If one small clot falls across the next valve it can be ejected like a bullet and often goes to the brain leading to stroke.
Who is at risk for afib?
Thankfully we know quite a bit about this atrial fibrillation and how to treat it.
We know atrial fibrillation is associated with the following risk factors:
- Sleep apnea, especially if untreated is one of the most common causes
- High blood pressure, again, especially if untreated
- Heart valve issues or prior history of open heart surgery
- Heavy alcohol use
- Excessive stimulant use (caffeine, cold medicines, and other illicit substances)
- Heart failure
- Family history of atrial fibrillation or unexplained stroke
- Age, particularly over 65
How is afib detected?
Not everyone has symptoms associated with atrial fibrillation but for those that do, typically a heart monitor is used by your doctor to identify irregular heartbeats or “palpitations.” There are times it is discovered during routine physical exam, and also newer home blood pressure cuffs have an “irregular heart beat” icon on the screen alerting patients to an issue. The most interesting, and newest addition is the Series 4 Apple iWatch, which has a built in algorithm and technology to detect atrial fibrillation. But if you have symptoms of irregular heartbeats or any concerns that you may be at risk, it is best to talk to your primary care physician or a cardiologist.
How is afib treated?
The four main areas of treatment revolve around addressing the contributing risk factors, slowing the heart down if needed with medications, decreasing the risk of stroke with blood clot prevention medications, and restoring normal rhythm through medication and/or procedures. Every case of atrial fibrillation is unique. Your cardiologist will determine which course of treatment is best for you.
So as you sit down this Valentine’s day with the one(s) you love, listen to your heart, both figuratively and literally. If you have concerns, you can always reach out to us at Minneapolis Heart Institute at Ridgeview Medical Center.