ATRIAL FIBRILLATION

Early detection and management of AFib are essential for reducing the risk of complications and improving overall heart health. Here are explanations for each of the common symptoms associated with atrial fibrillation (AFib):

• Heart Palpitations: Atrial fibrillation often leads to irregular and rapid heartbeats. Palpitations are the sensation of a fluttering, racing, or pounding heart. These irregular heartbeats can be unsettling and may feel like the heart is "skipping a beat."

• Daze: Some individuals with AFib may experience a feeling of mental fogginess or daze, often referred to as "brain fog." This symptom can result from reduced blood flow and oxygen delivery to the brain due to irregular heart rhythms.

• Dizziness: Dizziness or light-headedness can occur in AFib due to the irregular pumping of blood from the heart. When the heart is not effectively moving blood, it can lead to reduced blood flow to the brain, causing dizziness.

• Fatigue: Chronic fatigue is a common symptom of AFib. The irregular heartbeat and inefficient pumping of blood can result in decreased oxygen delivery to the body's tissues and organs, leading to fatigue and a lack of energy.

• Shortness of breath: Atrial fibrillation can make it difficult for the heart to pump blood effectively, which can lead to shortness of breath, especially during physical activity or even at rest. Individuals may feel like they can't catch their breath.

• Chest pain: Some people with AFib may experience chest discomfort or pain, often described as a pressure or squeezing sensation. This symptom can be concerning and should be evaluated by a healthcare provider to rule out other heart-related issues.

• Difficulty exercising: AFib can limit a person's ability to engage in physical activities and exercise. The irregular heart rhythm and associated symptoms like shortness of breath and fatigue can make exercise challenging.

Atrial fibrillation can be classified as:  

• Paroxysmal Atrial Fibrillation: This type of AFib is characterised by episodes of irregular heartbeats that start suddenly and usually resolve on their own within 7 days, often within 24 hours. The heart then returns to its normal rhythm.

• Persistent Atrial Fibrillation: In this type, the irregular heartbeat persists for more than 7 days. It does not self-terminate and requires medical intervention to restore normal rhythm.

• Long-Standing Persistent Atrial Fibrillation: When atrial fibrillation has persisted for more than one year, it is considered long-standing persistent AFib. This type often requires a more comprehensive treatment approach.

• Permanent Atrial Fibrillation: When attempts to restore normal rhythm have been unsuccessful or not pursued, and the irregular rhythm becomes a stable pattern, it is considered permanent AFib. Medical treatment focuses on controlling the heart rate and managing symptoms rather than restoring normal rhythm.

• Non-Valvular Atrial Fibrillation: This refers to AFib that occurs in the absence of significant heart valve disease. It is the most common type of AFib and is usually associated with risk factors such as age, hypertension, and diabetes.

• Valvular Atrial Fibrillation: This type is associated with significant heart valve disease, such as mitral stenosis or mechanical heart valves. Management may involve both addressing the valve disorder and managing the arrhythmia.

• Lone Atrial Fibrillation: This term is used when AFib occurs in younger individuals without any identifiable underlying heart disease. It often requires close monitoring and individualised treatment.

• Secondary Atrial Fibrillation: AFib can also occur as a result of other medical conditions, such as acute illness, surgery, or certain medications. It is usually temporary and resolves once the underlying cause is addressed.

Multiple risk factors can interact and increase the likelihood of AFib. AFib can also occur without any known underlying cause and may be classified as "idiopathic" or "lone AFib." Here's some more detail about each of these causes:

• Congenital heart defect: Some individuals are born with structural abnormalities in their heart, known as congenital heart defects. These defects can disrupt the normal electrical pathways of the heart and increase the risk of developing AFib.

• High blood pressure (Hypertension): Persistent high blood pressure can lead to changes in the heart's structure and function, increasing the likelihood of AFib. Elevated blood pressure can cause the heart's upper chambers (atria) to enlarge, which can contribute to the development of AFib.

• Coronary artery disease: Coronary artery disease (CAD) is characterized by the narrowing or blockage of coronary arteries that supply the heart with blood. CAD can impair blood flow to the heart muscle, potentially leading to AFib.

• Pulmonary disease: Certain lung conditions, such as chronic obstructive pulmonary disease (COPD) or pulmonary embolism, can increase the risk of AFib. These conditions can affect the balance of oxygen and carbon dioxide in the blood, which can impact heart function.

• Heart attack (Myocardial Infarction): A heart attack occurs when there is a blockage in one or more of the coronary arteries, leading to damage to the heart muscle. A heart attack can disrupt the heart's electrical system and contribute to AFib.

• Sleep apnoea: Sleep apnoea is a sleep disorder characterised by brief interruptions in breathing during sleep. It has been associated with an increased risk of AFib, possibly due to the stress it places on the heart and the potential for low oxygen levels during apnoea episodes.

• Sick sinus syndrome: Sick sinus syndrome refers to a group of heart rhythm disorders where the heart's natural pacemaker (the sinus node) does not function correctly. This can result in abnormal heart rhythms, including AFib.

• Thyroid problems: Both an overactive thyroid (hyperthyroidism) and an underactive thyroid (hypothyroidism) can increase the risk of AFib. Thyroid hormones play a critical role in regulating heart function.

The choice of medication(s) for managing AFib depends on several factors, including the type of AFib (paroxysmal, persistent, or permanent), the presence of underlying heart conditions, the individual's overall health, and their risk of stroke. In some cases, a combination of medications or additional therapies like electrical cardioversion or catheter ablation may be considered.

• Digoxin: Digoxin is a medication that helps regulate the heart rate in individuals with AFib. It works by increasing the strength of heart contractions and slowing down the heart rate. While it can be effective for some patients, it is less commonly used as a first-line treatment for AFib today compared to other medications.

• Anticoagulants: Anticoagulant medications, also known as blood thinners, are prescribed to reduce the risk of blood clot formation in individuals with AFib. AFib can lead to the pooling of blood in the heart's atria, increasing the risk of clots that can cause strokes. Common anticoagulants for AFib include:

Savaysa (edoxaban)

Xarelto (rivaroxaban)

Jantoven and warfarin: These are traditional anticoagulants that have been used for many years. They require regular monitoring of blood levels and diet restrictions because their effectiveness can be influenced by vitamin K intake.

• Antiarrhythmics: Antiarrhythmic medications are prescribed to restore and maintain a normal heart rhythm in individuals with AFib. There are different classes of antiarrhythmics, each targeting specific aspects of the heart's electrical activity. The choice of antiarrhythmic medication depends on the type and severity of AFib and the individual's overall health. Some common antiarrhythmic drugs include amiodarone, flecainide, and propafenone.

• Beta-blockers: Beta-blockers are medications that slow down the heart rate and reduce the force of heart contractions. They are often prescribed to control heart rate in individuals with AFib and to help manage symptoms like palpitations and chest discomfort. Common beta-blockers used for AFib include metoprolol, atenolol, and propranolol.

There are natural approaches and lifestyle modifications that may help individuals with atrial fibrillation (AFib manage their condition and improve overall heart health. Here's an explanation of each of the mentioned natural treatments:

• Follow a healthy diet to boost heart health: A heart-healthy diet typically includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats. Reducing sodium intake can help control blood pressure, which is important for managing AFib.

• Avoid heavy alcohol consumption: Excessive alcohol consumption can trigger or worsen AFib episodes in some individuals. It's advisable to limit or avoid alcohol, especially if it appears to be a trigger for AFib.

• Maintain a healthy weight: Obesity and excess body weight can increase the risk of AFib and contribute to other heart-related problems. Losing weight through a balanced diet and regular exercise can help manage AFib and improve overall heart health.

• Keep cholesterol levels down: High cholesterol levels can contribute to atherosclerosis (narrowing of the arteries), which can increase the risk of AFib. A heart-healthy diet and, if necessary, cholesterol-lowering medications can help manage cholesterol levels.

• Stop smoking: Smoking is a major risk factor for heart disease and can worsen AFib. Quitting smoking is one of the most effective steps individuals with AFib can take to improve their heart health.

• Lower caffeine intake: Caffeine can stimulate the heart and potentially trigger AFib episodes in some individuals. Reducing caffeine intake from sources like coffee, tea, and energy drinks may be beneficial.

• Regular physical exercise: Regular exercise can help improve cardiovascular fitness and reduce the risk of AFib-related complications. It's important to discuss an exercise plan with a healthcare provider, as excessive or intense exercise may need to be avoided in some cases.

• Reduce stress: Stress and anxiety can exacerbate AFib symptoms. Stress reduction techniques such as relaxation exercises, meditation, and mindfulness can help manage stress and improve overall well-being.

• Drink plenty of water: Staying well-hydrated is important for overall health and may help maintain proper blood flow and hydration of heart tissues.

• Acupuncture: Some individuals with AFib explore acupuncture as a complementary therapy to manage symptoms and promote relaxation. Acupuncture involves the insertion of thin needles into specific points on the body and is believed to have potential benefits for stress reduction and overall well-being.