Atrial fibrillation is heavily reported in the South. Here’s what AFib is and what to do about it.
If you feel your heart pounding a little too often, that’s probably not love or excitement so much as atrial fibrillation.
What is AFib?
Atrial fibrillation, or AFib, is a common type of heart arrhythmia in which the heartbeat can be too fast, too slow or irregular.
It’s all too common, as it turns out, and heavily reported in the South. According to the Centers for Disease Control and Prevention, AFib affects between 2.7 million to 6 million people, and while it’s more prevalent in women and in people over 65, it can happen at any age to any gender. As for why people are hospitalized more often in Southern states, it is most likely because some AFib risk factors, such as obesity and diabetes, are more common here.
Cardiologist Christopher Ellis, M.D., of Vanderbilt Heart said AFib isn’t something that resolves on its own, and it can lead, in extreme cases, to heart failure or stroke. In fact, the CDC estimates, people with AFib are five times more likely to suffer stroke, and it tends to be more severe. “The heart rhythm is an electrical coordination to keep the chambers pumping in the most efficient manner they can,” Ellis said. “Normally a very regular signal comes from your natural pacemaker cells. When the rhythm is disrupted… the patient can go into atrial fibrillation.”
Is atrial fibrillation a serious condition? Sometimes, people spontaneously come out of AFib just as unexpectedly as they go into it, Ellis said. But it’s important to pay attention when you’re experiencing symptoms such as fatigue, shortness of breath and a pounding heart for seemingly no reason. “Some people go into it briefly — 30 minutes, a few hours, a day or two. Some get stuck in it the rest of their lives. To the degree that we can get you from getting stuck in perm AFib, we can cut your stroke risk in half.”
What causes AFib?
Genetics certainly play a role, Ellis says, as does obesity, primarily because patients with obesity tend to suffer from high blood pressure and sleep apnea more often, both of which are contributing causes of AFib.
“It may be as simple as reducing foods that cause reflux,” Ellis said. “Hot, spicy foods and alcohol — if you’re prone to AFib, that may set it off more.”
The CDC names other risk factors, including:
- Advancing age
- High blood pressure
- European ancestry
- Heart failure
- Ischemic heart disease
- Chronic kidney disease
- Heavy alcohol use
- Enlargement of the chambers on the left side of the heart
AFib treatment options
Luckily, there are options.
It’s important to get an exam and an EKG, Ellis said, because the nature of AFib is often fleeting. “It may be hard for people to catch it when they notice a symptom,” he said. “One thing I find useful is to have the patient have their own heart rhythm monitoring tool. AliveCor, for instance, is a pretty darn accurate EKG app you can use with your smartphone; they give you a little electrode with it. That’s at least a start… patient-triggered monitoring is the most helpful thing.”
Other devices, like a Fitbit, are also useful. “Most patients have a resting heart rate between 50 to 90. If it’s consistently over 90 beats a minute, you have to think it’s abnormal, and you should make an appointment with your doctor.”
Ellis cautioned against relying on home blood pressure cuffs. Even one extra heartbeat, which is fairly normal, can register on a cuff as irregular, but it might be nothing to worry about. “A lot of people bring these into the office and think it’s irregular. It may be just a PVC (a premature ventricular contraction); everybody has those. It’s basically a skipped heartbeat.”
A WATCHMAN implant is an option in which a device is put in place to permanently block off a part of the left atrial appendage where blood tends to pool due to AFib, essentially keeping blood clots from escaping and reducing risk of stroke. It’s an alternative some patients prefer to being on blood thinners for the rest of their lives.
And, as with many diseases, prevention is a key treatment option for AFib. Ellis recommends his patients try to get their Body Mass Index below 30 and keep their blood pressure below 120/70. He also says it helps to avoid caffeine after 2 p.m. and to avoid consuming two or more alcoholic beverages a night.
“It’s become more like disease management,” he said. “You’ve got to do some things to mitigate your own risk.”
The Vanderbilt Heart and Vascular Institute‘s team treats all types of cardiovascular diseases and conditions, from the common to the complex. Our team is consistently recognized by U.S. News & World Report among the best heart hospitals in the nation and the best in Tennessee. Our wide range of services are offered in convenient locations throughout the region.
Christopher Ellis, M.D., is associate professor of medicine and director of the Left Atrial Appendage Closure Program at Vanderbilt University Medical Center. His clinical practice and research interests focus on electrophysiology, ablation, atrial fibrillation and other arrhythmia.