New consumer patient research from the Dallas-based American Heart Association found 62% of patients with atrial fibrillation had no prior knowledge of the condition before being diagnosed.
AFib is a serious condition that can lead to blood clots, stroke, heart failure, and other heart-related complications.
KERA’s Sam Baker discussed AFib with Dr. Brian Le, a clinical cardiac electrophysiologist with Texas Health Dallas and Texas Health Physicians Group.
Dr. Le: They would have palpitations, they would have fatigue, they feel lightheaded, that something is off, especially when they exercise. They feel like they can't do as much, and they get short of breath with exertion.
Baker: And all of that stems from what? What exactly is atrial fibrillation?
The very root of AFib is where your heart beats out of rhythm. The heart is irregular and fast. And in the upper chamber, in layman's terms, it's going about 300 to 500 beats per minute.
So, there is no movement of blood. Blood is stagnant. It can pick it up from a clot, hence the risk of a stroke. And because the upper team is going so fast, the bottom chamber beats irregularly, chaotically, and very fast as well. Hence, the symptoms of fatigue and dyspnea on exertion. As they exercise, they get short of breath.
What causes this to begin with?
The most common cause is getting older. I call this a disease of the privileged. You've lived long enough that now all the wear and tear of life contributes to AFib.
A small variant called lone AFib happens in very young people. That's about 1% of the time.
The majority of atrial fibrillation is caused by us getting older and having some diseases that can contribute to causing AFib, such as high blood pressure and diabetes, obstructive sleep apnea, and lung disease.
There have been reports that cases of AFib are expected to double by 2030. There are about six million or more now in the U.S. What's driving this?
Well, because our medical technology has become so good, people are living longer. The longer you live, the more likely you are to see this disease. Especially in developed countries, we see much more AFib than in third-world countries.
Is AFib treatable or curable?
It is modifiable. So, I would borrow the same concept from cancer, that if you are AFib-free, when you have an ablation done, I would say that you are in remission.
It's important to focus on lifestyle changes to keep AFib away:
- control your diabetes,
- control your blood pressure,
- get treated for obstructive sleep apnea,
- and most importantly, lose weight.
Those are the best guides against AFib?
I think that it goes hand in hand. So, you can do all these lifestyle things that we mentioned to try to keep yourself from having AFib or having other diseases down the line.
But once you have AFib, proper treatments, such as being on a blood thinner, being on medication to control the heart rate, to keep you in rhythm, having an ablation done to promote regular rhythm, and then, in conjunction with all those things in parallel, to do all of the lifestyle changes to keep AFib away.
What's an ablation?
An ablation is where an electrophysiologist like myself enters the heart through an IV placed in the groin, and we can modify the substrate by targeting the areas, the pulmonary veins, that harbor the trigger for atrial fibrillation. By keeping the trigger from entering the heart, we can keep AFib away.
Furthermore, in the more advanced stages of AFib where there are more scars developed, we can render these scars inert so that they don't contribute to promoting atrial fibrillation.
RESOURCES:
Atrial fibrillation: New guidelines, new advice
New atrial fibrillation guideline: Modify risk, control rhythm, prevent progression
New research finds 62% of AFib patients were unaware of the condition before diagnosis
