Atrial Fibrillation - How Can It Hurt Me?

Atrial fibrillation (AF) is on the rise and by 2030 it is expected to affect at least 12 million people in the U.S..  It is a chaotic, irregular beating of the small heart chamber, (atrium) which is transmitted to the large chamber, (ventricle), on a “hit or miss” basis.  AF is more common among men than women; it marks the growth of our aging population.  Other risk factors for this disordered pacing of the heart include hypertension, smoking, high alcohol use, thyroid disease, heart disease, diabetes and sleep apnea.

Can AF Hurt Me?  Yes, AF increases risk of death by at least 1.5 times.  AF is also associated with an increased incidence of stroke, heart failure, heart attack, chronic kidney disease and dementia.  AF may also tend to occur in families.

How Do I Know I Have AF?  Sometimes it is silent.  Or, perhaps it gets your attention because you perceive a racing pulse or skipping of beats (palpitations).  Sometimes you notice difficulty exercising and shortness of breath or a general sense of fatigue.  Chest tightness or pressure is another sign. Swelling can occur in the feet and legs.  To know for sure, your doctor will need an electrocardiogram (EKG).  An ultrasound (cardiac echo) would probably also be done.

      EKG strip of A Fib

EKG shows irregular rhythm and not all atrial beats produce a corresponding ventricular beat.  aclsmedicaltraining.com 

What Can I Do To Decrease My Risks?  Start with lifestyle modification and control the risk factors.  Stop smoking, lose weight and severely limit alcohol intake.  Based on an atrial fibrillation risk score calculator, (https://www.mdcalc.com/calc/801/cha2ds2-vasc-scoreatrial-fibrillation-stroke-risk)if your stroke risk is 2% or higher, you may be advised to use a blood thinner (anticoagulant) to lower stroke risk. Symptom control of a rapid rate may require medication.  Surgical treatment by removing the left atrial appendage or intravenous catheter ablation (zapping an area in the heart with heat or cold) are other common treatments.  AF recurs in 40% of those treated with ablation.

Key Points:

  • AF is a risky condition that requires timely medical attention.
  • While heart disease is in itself a problem, a complication of stroke may result from neglected AF.
  • See your physician if you suspect a problem - the evaluation is an easy experience.   

Medical Tip from Dr. Charles Driscoll, VASSAR Surgeon General

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References:

  1. Arnold, MJ Management of  Atrial Fibrillation: Guidelines From the American College of Cardiology and American Heart Association. Am Fam Physician. 2025;111(2):183-184.