male patient on treadmill being tested for Atrial fibrillation (AFib)

What is AFib?

Atrial fibrillation (AFib) is the most common type of heart arrhythmia, or irregular heartbeat. When you are living with AFib, the electrical signals that regulate your heartbeat are interrupted by chaotic signals, making the upper chambers of the heart (the atria) contract irregularly.

Working with a cardiologist and an electrophysiologist, you can manage AFib and protect your long-term health.

AFib symptoms

AFib doesn’t always cause symptoms. When symptoms do occur, you might notice them only occasionally.

If you experience any of these symptoms, track how often they occur, what you are doing when they happen and whether symptoms change over time. This is important information to share with your healthcare provider.

doctor checking a patients blood pressure

What causes AFib?

AFib develops due to inflammation of, stress on or damage to heart tissue, which often occurs due to other conditions. These include:

  • Heart disease, such as cardiomyopathy, coronary artery disease and heart valve disease 
  • High blood pressure
  • Endocrine disorders, such as diabetes and hyperthyroidism
  • Obstructive sleep apnea
  • Inflammation from myocarditis and pericarditis 
  • Chronic obstructive pulmonary disease (COPD)
  • Sick sinus syndrome
  • Viral infections
  • Chronic kidney disease
  • Obesity

Risk factors for atrial fibrillation

For some people, strenuous physical activity can lead to a higher risk of AFib. However, moderate exercise can help lower your risk and following a healthy lifestyle can help prevent some of the causes of AFib.

Many factors are linked to an increased risk of developing AFib. These include

  • Advancing age
  • Family history and genetics
  • Having certain health conditions, [such as high blood pressure]
  • Race, as AFib happens more commonly among Caucasian populations
  • Surgery on your heart, lungs or esophagus

Lifestyle factors also play a big role in AFib risk, including:

  • Excessive consumption of alcohol
  • Having high amounts of emotional stress
  • Smoking
  • Using illegal drugs
Atrial fibrillation (AFib) patient relaxing on the couch

Complications

Blood clots are a serious complication of atrial fibrillation and can lead to stroke.

The risk of stroke from AFib increases with age and is heightened by other conditions like high blood pressure, diabetes, heart failure, and certain types of heart valve disease.

How is AFib diagnosed?

If you have AFib symptoms, your doctor will make a diagnosis based on a physical exam and testing.

In most cases, an electrocardiogram (EKG) will be done first. This noninvasive test records the electrical activity of your heart and shows your doctor whether your heart is beating irregularly.

Other tests, such as blood tests, chest X-rays and other tests, can help your doctor determine the cause of AFib and find the best course of treatment.

If you have risk factors for AFib, your doctor might recommend screening for the disease condition as part of your routine medical care.

If more information is needed to make a diagnosis, your doctor may also do other tests, such as:

  • Echocardiogram: This is an ultrasound that provides a detailed image of the heart’s structures. It can also detect blood clots and areas of the heart that are not functioning correctly.
  • Event recorder: This portable device records your heart rhythm when you have symptoms and transmits the information back to your doctor.
  • Holter monitor: Typically worn for 24- to 48-hour periods, this portable device continuously monitors the heart’s electrical activity.

AFib treatment

​​​​​​​​​​​​​AFib treatment depends on the cause and severity of the condition. Medicine and lifestyle changes may not improve your symptoms. In those cases, your doctor may recommend surgery or a minimally invasive cardiac catheter ablation procedure.

Lifestyle changes

Your healthcare provider may suggest several lifestyle changes to improve your heart health. These include regular physical activity and following a heart-healthy diet that is low in salt, saturated fats, trans fats, and cholesterol. It’s also important to manage high blood pressure and limit your intake of alcohol and caffeine. Quitting smoking and controlling your alcohol intake along with cholesterol levels can further support your heart health. Additionally, maintaining a healthy weight is essential for overall well-being.

Medication

Healthcare providers commonly prescribe medications to prevent and treat blood clots that could lead to a stroke. They may also recommend additional medications to help control your heart rate and rhythm, often combined with other treatments.

Cardioversion therapy

If atrial fibrillation symptoms are affecting your day-to-day activities or it's a first episode, doctors may use cardioversion to reset the heart's rhythm.

There are two methods:

  • Electrical cardioversion: This procedure brings your heart rhythm back to normal with low-energy electrical shocks.
  • Chemical cardioversion: Medications are given through an IV or orally to restore the heart's rhythm.

Cardioversion is usually a scheduled hospital procedure but can be done in emergencies. Blood thinners may be required beforehand to reduce the risk of clots and stroke, and are essential for at least a month after the cardioversion. Afterward, ongoing medication may be needed to control the rhythm and prevent recurrence, though AFib can still return.

Ablation

If medications or other treatments don’t improve AFib, a minimally invasive procedure called catheter ablation may be needed. In some cases, ablation is used as the first line of treatment. Treatments may include:

  • Convergent hybrid ablation: Performed by your cardiac surgeon and electrophysiologist, this procedure involves using radiofrequency (heat) to create scar tissue on the heart that blocks irregular electrical signals.
  • Cryoablation: Similar to the procedure above, this procedure creates scar tissue that disrupts electrical signals. However, instead of using radiofrequency, cryotherapy uses extremely cold temperatures applied through specialized catheters.
  • Cryoballoon ablation: This is a type of cryotherapy ablation often used to treat paroxysmal AFib, a type of AFib that comes and goes often within seven days. Cold temperatures are applied through a balloon that inflates once inside your body.
  • Radiofrequency ablation: Radiofrequency ablation uses a low voltage, high-frequency electrical energy to destroy tissue that causes irregular heartbeats.

Surgery

Surgical procedures for treating atrial fibrillation may include:

  • Left atrial appendage (LAA) occlusion therapy: Left atrial appendage (LAA) closure is a procedure that seals off the LAA to prevent blood clots from entering the bloodstream, reducing the risk of stroke in people with atrial fibrillation without the need for blood thinners.
  • Maze procedure: A surgeon applies energy through incisions to the outer surface of the heart to eliminate the conduction pathways of AFib.
  • Pacemaker: Your cardiologist may recommend a pacemaker if your heart rate is too slow, typically when you have another arrhythmia in addition to AFib.

Find a location near you

You can find comprehensive, advanced diagnosis and treatment for AFib at a location that fits your needs. We have many convenient heart and vascular clinics, including specialized centers in North and Central Texas.

Read More