Atrial Fibrillation (AFib)

Atrial fibrillation, also called AFib or AF, is a cardiovascular condition characterized by an irregular heart rhythm that can result in a rapid heart rate. This arrhythmia starts in the upper chambers (atria) of the heart. During an AFib episode, these chambers pump blood inefficiently at uneven rates and fall out of sync with the lower chambers (ventricles).

This heart rhythm disorder has been linked to a weakening of the heart muscle, heart failure, hospitalizations and an increased risk of stroke.

Some people with AFib don’t notice any symptoms. When symptoms do occur, they usually come and go, lasting for minutes up to an entire week. Because symptoms vary so much, tell your doctor if you notice any of these AFib signs:

• Dizziness or lightheadedness (with or without fainting)
• Fatigue
• Fluttering feeling in chest
• Shortness of breath
• Sudden, fast heart rate
• Weakness

What Does AFib Feel Like?

Unlike a normal, steady heartbeat, AFib can feel like rapid fluttering or pounding in your chest, also called heart palpitations. You may feel short of breath or lightheaded, too. As AFib progresses, these episodes of arrhythmia tend to last longer.

AFib Heart Rate

While a normal resting heart rate typically ranges from 60 to 100 beats per minute, heart rates during AFib can easily surge above 100 beats per minute. Because the heart rate is fast even when you’re resting, it's as if the heart is exercising all the time. This constant strain can lead to heart failure and heart failure symptoms from muscle fatigue.

AFib vs VFib

While AFib starts in the upper chambers, ventricular fibrillation (VFib) starts in the lower chambers and is an immediate threat to life. These are very different rhythm problems.

Because the ventricles are responsible for the actual delivery of oxygenated blood, VFib causes an immediate drop in blood pressure. This immediately deprives your brain and other organs of oxygen. Without a shock from a defibrillator to "reset" your heart’s rhythm right away, a person in VFib will go into sudden cardiac arrest within seconds.

What Causes AFib?

AFib can occur in otherwise healthy hearts. It is also common to see when there have been changes to the heart’s physical structure. Medical conditions and surgical procedures can contribute to these structural changes, including:

• Abnormal levels of electrolytes
• Chronic kidney disease
• Congenital heart defect
• Coronary artery disease
• Diabetes
• Heart attack
• Heart failure
• Heart surgery
• Heart valve disease
• High blood pressure
• Lung diseases, including pneumonia 
• Obesity
• Sleep apnea
• Thyroid disease
• Viral infections

Lifestyle habits also trigger AFib, such as:

• Alcohol use
  
• Anxiety
• Chronic stress
  
• Excessive caffeine intake
• Lack of physical activity
• Smoking or using tobacco products

Your risk for AFib increases as you age, too.

Is AFib Hereditary?

AFib can run in families. If you have a parent or sibling with AFib, your risk of developing the condition is higher. However, having a family history doesn't mean you'll definitely get AFib. Maintaining a healthy weight, limiting alcohol and tobacco use, and managing other risk factors such as high blood pressure, can help lower your risk.

Is Atrial Fibrillation a Medical Emergency?

If you have symptoms of AFib for the first time, seek treatment by a cardiac electrophysiologist right away. Doctors may need to run cardiac and imaging tests to check if your abnormal heart rate is caused by AFib or another heart disease.

An AFib episode is rarely a medical emergency, but it's still important to seek medical attention to help prevent complications.

While AFib itself isn’t usually immediately life-threatening, it can lead to serious problems like blood clots, heart failure, heart attack or stroke. These are medical emergencies that need to be treated right away. If you, or someone around you, shows signs of a heart attack or stroke, call 911.

Treatment Options for AFib

Talk to your primary care provider if you have symptoms of AFib. They can connect you with a UnityPoint Health electrophysiologist, a doctor who specializes in treatments for AFib. In the early stages, treating AFib requires making lifestyle changes to control the condition. This includes getting enough quality sleep, managing stress, quitting smoking, exercising regularly and eating a diet low in salt and saturated fats.

Medications for AFib

Based on your health history, your doctor may also prescribe medications to keep your heart steady, including:

• Blood thinners to prevent blood clots
• Heart rate-controlling medications, such as beta blockers, calcium channel blockers or digoxin
• Heart rhythm medications such as sodium channel blockers or potassium channel blockers

Interventions

Catheter ablation is the best long-term treatment option for most patients with AFib. During ablation for AFib, a doctor uses a thin tube (catheter) to apply energy in the areas of the heart where the abnormal electricity is coming from. The goal is to block the irregular electrical pulses that cause AFib. These catheters are typically inserted through veins in the groin, and the procedure is usually performed on an outpatient basis. Recent research shows that earlier intervention with ablation improves long-term outcomes and can limit heart failure, stroke risk, and hospitalizations while improving quality of life. Another benefit to ablation is that it doesn’t expose patients to medication side effects.

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