Atrial Fibrillation: What’s My Prognosis?
When Your Heart Skips a Beat
Abnormal heart rhythms like atrial fibrillation (AFib) can be serious. Not only are the symptoms frightening, but the complications can be fatal. According to the results of a study published in the Journal of the American Medical Association (JAMA), more than 2.3 million adults in the United States currently have AFib. By 2050, more than 5.6 million will be affected.
Click through the slideshow to find out what do you need to know about atrial fibrillation and your long-term health.
What Is Atrial Fibrillation?
AFib is a cardiac arrhythmia in which the regular rhythmic beating of the heart muscle is disturbed. Usually because of faulty electrical signals, the muscles in the two upper chambers of the heart (the atria) contract irregularly and transmit rapid pulses to the lower chambers. This can cause blood to pool in the heart rather than move into the lower part of the heart and through the body. When blood pools, clots can form. This increases the risk of stroke or blockage in blood vessels anywhere in the body. Chest pain and heart failure also can occur.
All AFib Is Not the Same
Sometimes AFib is a singular occurrence due to factors such as heart disease, stress, medications, or nicotine. This is called paroxysmal atrial fibrillation. It begins suddenly and usually stops on its own within 24 hours. It can be severe or very mild, and may last up to one week.
Persistent atrial fibrillation is a longer-term arrhythmia, lasting longer than one week. Normal heart rhythm can return on its own or with medical treatment.
Chronic Atrial Fibrillation
AFib occurs when the electrical impulses of the heart are not transmitted normally. If the system is permanently damaged, chronic AFib may result.
Permanent or chronic atrial fibrillation occurs when normal heart rhythm can’t be restored. Paroxysmal and persistent AFib can result in chronic AFib over time, which can lead to complications like stroke and heart failure.
Progressing from paroxysmal AFib to chronic AFib increases your risk for complications. Risk factors like heart valve disease and excessive alcohol consumption can make this progression more likely.
Causes of AFib
Possible causes of atrial fibrillation include:
- heart valve problems or heart defects
- high blood pressure
- stimulant medications
- binge drinking, and nicotine
- overactive thyroid gland
- sick sinus syndrome
- lung disease
- certain viral infections
- stress, especially due to illness like pneumonia
- sleep apnea
Some of these factors can’t be controlled. However, you can reduce your risk for AFib if you take care of yourself.
Opportunities for Prevention
You can reduce your risk for AFib by changing some behaviors. Cutting down on your intake of alcohol may help prevent an attack. Stop smoking and using nicotine products, and avoid over-the-counter medications that have stimulant properties like pseudoephedrine, found in some cold medications.
Make sure any health conditions you have are being properly treated. High blood pressure, thyroid conditions, and sleep apnea can all respond to medication or therapy and prevent AFib episodes. Work to reduce stress in your life and maintain a healthy weight.
Keeping Your Rhythm Right
Treatment of AFib involves resetting your heart’s rhythm or controlling your heart rate.
Resetting your heart rhythm can involve taking medications (such as amiodarone or propafenone) or resorting to electrical shock treatment. Medications can also be given after normal rhythm returns to prevent a reoccurrence.
If your rhythm can’t be reset, controlling your heart rate is important for the long-term health of your heart. Your doctor may prescribe medications like digoxin or beta-blockers. They may suggest surgery to remove a damaged AV node and replace it with a pacemaker.
Clots Can Kill
Preventing blood clots is an important part of your AFib treatment plan. The blood clots that may form inside your heart due to arrhythmias can travel to your brain, lungs, gut, and throughout your body, blocking blood vessels. This prevents blood from getting to an area and causes severe damage. Medications like warfarin (Coumadin), dabigatran (Pradaxa), and rivaroxaban (Xarelto) can help prevent blood clots. However, you must be monitored while taking these.
Silent but Deadly
Some people may have silent AFib. That means they don’t experience the usual symptoms associated with AFib such as palpitations, lightheadedness, chest pain, and shortness of breath.
If you’ve been diagnosed with AFib but don’t experience symptoms, you can still be at risk for blood clots and heart damage over time. Taking medications to restore heart rhythm and preventing blood clots will help your long-term health.
Prognosis by Numbers
The Framingham Heart Study has shown that people with AFib have a risk of death 1.5 to 1.9 times as high as people without AFib but with other conditions.
The risk of ischemic stroke (stroke due to a clot) is 5 times greater in people with AFib, accounting for 15 percent of all strokes in the United States.
More than 2.3 million people in the United States have AFib, half of whom are over the age of 80. Only 0.1 percent of people under 50 have AFib.
If you’ve just been diagnosed with AFib, talk to your doctor about what type you have.
Ask about what lifestyle changes may help to reduce your risk of aggravating your condition. Follow up to make sure your medications are up to date, and any other health conditions are being treated properly.
AFib is a serious condition, but you can still live a normal, active life.
- What is atrial fibrillation? (July 2011) National Heart, Lung and Blood Institute. Retrieved June 25, 2013 from http://www.nhlbi.nih.gov/health/health-topics/topics/af/
- Benjamin, E et al. (1998) Impact of Atrial Fibrillation on Risk of Death. Circulation. 98:946-952. Retrieved June 26, 2013 from http://circ.ahajournals.org/content/98/10/946.abstract?ijkey=d7b977077fa7f76a907a5a2a676f9b68668d8ad4&keytype2=tf_ipsecsha
- Go, A et al. (May 2001) Prevalence of Diagnosed Atrial Fibrillation in Adults. JAMA. 285, No 18:2370-2375. Retrieved June 26, 2013 from http://jama.jamanetwork.com/article.aspx?articleid=193807
- Lip, GYH and Li Saw Hee, FL. (2001) Paroxysmal atrial fibrillation. QJM. 94(12): 665-678. Retrieved June 27, 2013 from http://qjmed.oxfordjournals.org/content/94/12/665.full
- Atrial fibrillation. (February 2013) Mayo Clinic. Retrieved June 27, 2013 from http://www.mayoclinic.com/health/atrial-fibrillation/DS00291
- Ruigomez, A et al. (2005) Predictors and prognosis of paroxysmal atrial fibrillation in general practice in the UK. BMC Cardiovascular Disorders. 5:20. Retrieved June 27, 2013 from http://www.biomedcentral.com/1471-2261/5/20