A Common Heart Problem That is Often Ignored

What can you tell me about atrial fibrillation? Every so often, I have noticed my heart starts beating rapidly for no particular reason. Is this something I should be worried about?

Heart palpitations can be harmless if they are brief and infrequent. But if you are experiencing an erratic heart rhythm, you need to get examined by a doctor for atrial fibrillation, also known as AFib.

AFib – which is marked by rapid, fluttering beats – can lead to serious complications such as stroke and heart failure when the weakened heart is unable to pump enough blood to the rest of the body.

Normally, your heartbeat follows a steady rhythm as your heart contracts and relaxes. But when you have AFib, the upper chambers of your heart (atria) beat rapidly and irregularly, sending blood to the lower chambers (ventricles) less efficiently. These episodes can last for minutes to hours (or longer), and can cause palpitations, lightheadedness, fatigue and/or shortness of breath. Over time, AFib tends to become chronic.

Age is a common risk factor for AFib. It affects roughly 10% of people older than 75. Other factors include genetics, obesity, diabetes, high blood pressure and alcohol and tobacco use. The condition has also been linked to viral infections, including COVID-19.

Diagnosing AFib

If you are experiencing AFib-like symptoms, you should consult a doctor. The physician will listen to your heart and likely recommend an electrocardiogram (EKG) or a treadmill heart test. The doctor may also recommend you wear a portable monitor for several weeks to look for abnormal heart rhythms to confirm a diagnosis of AFib. Such tests can help distinguish AFib from less serious conditions that may cause the heart to flutter, like anxiety and stress.

AFib affects about three million adults in the United States, a number that is expected to quadruple in the coming decade as the population ages and risk factors like obesity, diabetes and high blood pressure become even more common. The lifetime risk of developing AFib is greater than 20%, yet many people are unaware they have it.

Treatment Options

A growing body of research underscores the importance of lifestyle steps such as exercise, a healthy diet and limiting alcohol for treating AFib.

Depending on your age and symptoms, your doctor may prescribe medication to help control your heart rate. Some of those include beta blockers such as metoprolol (Toprol XL) and/or rhythm, such as antiarrhythmics like flecainide (Tambocor).

Some individuals may need an electrical cardioversion, an outpatient procedure that delivers an electrical shock to the heart to restore a normal rhythm. This procedure is brief and requires sedation.

Catheter ablation is another outpatient treatment for AFib that scars a small area of heart tissue, which causes irregular heartbeats. This procedure is becoming more common based on evidence of its safety and ability to normalize the heart rhythm and ease symptoms. Ablations can be effective in people 75 and older, but medication may still be required afterward.

If you are at higher risk for a stroke, you may be prescribed a blood thinner as well. In the past, Coumadin (warfarin) was the only blood thinning drug widely available, but it requires monitoring with regular blood tests. Newer anticoagulants, such as apixaban (Eliquis) and rivaroxaban (Xarelto), do not have that requirement and have been shown to be just as effective at preventing strokes.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.


Published April 15, 2022

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