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What You Need To Know To Take Charge of Your AFib

Understanding the factors putting you at greater risk for stroke.

If you have atrial fibrillation (often called AFib), you’re not alone. According to the Centers for Disease Control and Prevention (CDC), it affects between 2.7 and 6.1 million adults in the United States. And that number is expected to rise dramatically with the aging of the baby boomer generation.

“This is something we can treat at Calvert in a very comprehensive way,” said board-certified cardiologist Dr. Awail Sadiq of Chesapeake and Washington Heart Care in Prince Frederick, who is fellowship trained in interventional cardiology and is a structural heart disease specialist.

“There are some invasive procedures where people may need to go to a tertiary center,” said Dr. Sadiq, “but most of the care can be provided locally.” Being an informed advocate for yourself or a loved one is an important part of managing AFib, according to the American Heart Association (AHA).

Here, Dr. Sadiq answers some of the frequently asked questions about AFib, including who is at risk, what triggers it and treatment options.

What is AFib?

Atrial fibrillation is the most common cardiac arrhythmia (an abnormal or irregular rhythm). When a person has AFib, the heart’s upper chambers (the atria) beat irregularly or out of coordination with the lower chambers (the ventricles). There are different types of atrial fibrillation:

  • Occasional (paroxysmal) – AFib comes and goes, stops by itself and usually lasts less than 7 days.
  • Persistent – AFib lasts more than 7 days and doesn’t go away. Medications or procedures may help to restore normal rhythm.
  • Long-standing persistent – is continuous and lasts more than 12 months.
  • Chronic – medical interventions are unable to restore normal rhythm for a meaningful amount of time.

Who is at risk?

Atrial fibrillation becomes more common as people get older. Abnormalities or damage to the heart’s structure are the most common cause of AFib. Anyone with heart disease — such as heart valve problems, congenital heart disease, congestive heart failure, coronary artery disease or a history of heart attack or heart surgery — has an increased risk. High blood pressure, obesity, diabetes and sleep apnea are other possible risk factors.

What can I do to prevent AFib?

There are ways to lower your risk of developing AFib or to reduce its impact if you already have the condition. The AHA recommends a heart-healthy lifestyle:

  • Get regular physical activity
  • Eat a heart-healthy diet
  • Manage high blood pressure
  • Avoid excessive alcohol and caffeine
  • Control cholesterol
  • Maintain a healthy weight

How is AFib diagnosed?

Very often people may feel palpitations (a noticeably rapid or irregular heartbeat). Some may have increased fatigue or shortness of breath. As soon as you notice any symptoms of AFib – even if they go away – you should contact your doctor. If we find an irregular heartbeat, when we listen to your heart and check your pulse, the next step would be an electrocardiogram (ECG), which uses small electrodes placed on different areas of your body, including several on your chest, that give us a picture of your heart’s overall electrical activity.

What triggers AFib?

Some people may have more than one trigger at various times in their life and the triggers may not be so obvious. Recognizing triggers and avoiding them can help you manage AFib effectively. For instance, too much alcohol or certain stimulants such as energy drinks and caffeine can trigger AFib for some people. Acute stress from an illness such as pneumonia or a major surgery can also trigger AFib. So, too, can an overactive thyroid.

How is AFib treated?

There are two broad treatment strategies – rate control and rhythm control. In general, this can be achieved with medications called antiarrhythmics where the goal is to slow your heartbeat and bring it into a normal rhythm. If medications don’t work, another option is to shock the heart to restore the normal electrical activity of the heart. This procedure is called electrical cardioversion and is a common method for getting people out of AFib. If this proves ineffective, ablation may be recommended to correct the AFib.

Why is AFib associated with a greater risk for stroke?

This is because AFib allows blood to pool in the heart’s upper chambers, which could cause clots to form and travel to the brain. We calculate a patient’s risk for stroke based on specific criteria and what other medical conditions they might have such as high blood pressure or diabetes. If their risk is above a certain threshold we feel they would benefit from anticoagulants or blood thinners to reduce the risk for blood clot formation.
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