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The Fundamentals of AFib

Atrial fibrillation, or Afib, is an irregular heartbeat or a condition when the top part of your heart, or atria, fails to contract in a strong, rhythmic way. During Afib, the atria don’t completely empty, leaving blood to pool in the upper chamber, or left atrium. 

  • When blood pools in the left atrium, a clot can form. 
  • When a clot breaks loose, it can block the arteries feeding blood to the brain and cause a stroke. 
  •  Your heart may not be pumping enough blood out to the body, increasing your risk for heart failure. 

Causes

Possible Risk Factors for Afib include:

  • High blood pressure
  • Prior heart attack or heart disease 
  • Diabetes
  • Sleep apnea 
  • Excessive smoking 
  • Alcohol 
  • Prolonged athletic conditioning 

Common Triggers for Atrial Fibrillation 

  • Excessive alcohol 
  • Stress or anxiety 
  • Poor sleep and sleep apnea 
  • Energy drinks (normal amounts of coffee should not trigger Afib, but further study may be needed for energy drinks.) 

Symptoms 

  • Shortness of breath or fainting spell 
  • Fatigue, dizziness or lightheadedness 
  • A racing, fluttering, pounding or irregular-feeling heartbeat 
  • A feeling of anxiety 

Even if the symptom(s) go away, you should still contact your doctor if you notice symptoms of AFib. People with no symptoms may be diagnosed by an exam and an EKG. 

Types 

  • Paroxysmal 
  • Persistent 
  • Longstanding persistent 
  • Permanent 

Your treatment plan and outcome will depend on your type of Afib and other factors. Also, regular check-ups to monitor the condition and keep risks low are critical.

Treatment

In some cases, you may require medical intervention to restore your heart’s normal rate and rhythm. You may need medication or surgery to lower your stroke risks.

Medications

When you have Afib, the goal is to get your heart back into rhythm and prevent blood clots that can lead to a stroke. For many people with AFib, medication offers the best treatment option. 

Types of Afib medications your doctor might prescribe for you:

  • Rate control medication helps lower the heart rate and regulate the pace of electrical currents that are sent from the atria to ventricle.
  • Rhythm control medication helps keep the heartbeat patterns or rhythms normal.
  • Anticoagulants or “blood thinner” medications
    • reduce the risk for blood clot formation that can lead to a stroke or
    •  treat an existing blood clot
    •  require monthly blood tests, dietary considerations, and monitoring for the possibility of uncontrolled bleeding
  • Direct-acting anticoagulants (DOACs)
    • A class of newer medications that require less monitoring
    • may reduce the risk of bleeding
    • work and clear the system faster than some well-known anticoagulants

FAQs

Q. Do I need to wear a medical alert bracelet or carry a card in my wallet?
A. In any emergency, knowing your medical history is vital to your health care providers. If you’re taking an oral anticoagulant medication (blood thinner), always wear a medical alert bracelet or carry a wallet card that lists the medication you’re taking and the dose.

Q. Can I still drive my car, exercise, have sex, or perform other activities of daily living?
A. If your physician allows, you should be able to perform any activity that you’re able to
tolerate. Should you experience dizziness or even fainting while performing an activity, STOP. Discuss with your health care provider how to know if and when your AFib symptoms need to be checked by a medical professional.

Q. I have Afib, but no symptoms. Am I still at risk for stroke?
A. Yes! Keep taking medications although you’re not having obvious symptoms. Many people with AFib should be on anticoagulant medications, which lower the risk for stroke when taken correctly.

The greatest risk of AFib is stroke—you are 5x more likely to have a stroke than someone who doesn’t have atrial fibrillation. You also have a risk of eventual heart failure due to the weakening of the heart muscle.

Know your stroke risk score.

  •  You and your doctor MUST communicate accurately about your level of risk for stroke.
  • Discuss your score with your doctor.
  • Without risk-lowering treatment, nearly 35% of people Afib eventually have a stroke.
  • Helpful tools can help you better understand your risk score.

Follow your treatment plan.

If you are prescribed medication, keep taking it unless you and your doctor decide together to change it.

Act F.A.S.T. -Warning Signs of Stroke

F - FACE DROOPING
A - ARM WEAKNESS
S - SPEECH DIFFICULTY
T - CALL 9-1-1 NOW

Other warning signs that you may be having a stroke:

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body
  • Sudden confusion, or difficulty speaking/ understanding speech
  • Sudden difficulty seeing in one or both eyes
  • Sudden difficulty walking, dizziness or loss of balance
  • Sudden severe headache with no known cause

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