Expert advice on diagnosing and treating atrial fibrillation

Mellanie True Hills Founder and CEO, and the American Foundation for Women’s Health

Atrial fibrillation, often called “afib,” is an irregular heartbeat, a rapid heartbeat, or a quivering of the upper chambers of the heart, called the atria. Afib occurs because of a malfunction in the heart’s electrical system, and is the most common heart irregularity, or cardiac arrhythmia. According to the Mayo Clinic, afib affects more than 5.1 million people in the United States, and by 2050, the condition may impact the lives of more than 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to afib. In addition, people over the age of 40 have a one in four chance of developing afib in their lifetime. Fortunately, there are treatments that can reduce symptoms and even rewire the heart’s circuitry. To understand and treat afib, follow the expert advice below.


Do believe that afib is deadly serious

Afib may lead to blood pooling in the atria, which can create blood clots that break loose from the heart and move to the brain as a stroke. Not surprisingly, afib is a leading cause of strokes, and those with afib have a 500 percent greater risk of stroke than those without the condition. About 35 percent of afib patients will have a stroke at some time. In addition, afib strokes are fatal nearly three times as often as other strokes within the first 30 days. Afib can also lead to heart failure, dementia, and has been linked to Alzheimer’s disease.

Do diagnose afib with an EKG or ECG

Afib is diagnosed by an EKG or ECG (electrocardiogram) where several electrodes are placed on your skin to measure and record your heart’s electrical activity. It is painless and takes only a few minutes as you lie down for the test to be administered. You must be undergoing an episode of afib at the time of the EKG in order for it to be seen on the readout. This works best for patients in persistent or longstanding persistent atrial fibrillation. If your afib episodes are intermittent, as with paroxysmal atrial fibrillation, then they will not be recorded on the EKG unless you are in afib at the time, and you may need to wear a small portable heart monitor in order for your episodes to be captured.

Do seek an afib specialist

Not all general practice doctors are up to date on afib treatment options. Some may send afib patients home without appropriate treatment. And if medications don’t work, specialists can offer additional options for stopping afib. Specialists such as electrophysiologists can perform a catheter ablation on the inside of the heart that blocks erratic electrical impulses from entering the heart. Surgeons can offer similar procedures on the outside of the heart, such as minimally invasive surgical ablation or an open-heart surgical ablation.

Do realize that different people have different afib symptoms

Some patients describe afib as feeling like skipped heartbeats, followed by a thud and a speeding up or racing of the heart. Others describe it as an erratic heartbeat, strong heart palpitations, or simply a rapid heart rate. For some, it feels like fluttering, butterflies, or even a flopping fish in the chest. Others have chest and throat pressure that mimics a heart attack. For some people, afib doesn’t stop, and may continue on for hours, days, weeks, months, or even years.

Do pay close attention to your heartbeat if you have heart disease

Atrial fibrillation is common among those with coronary heart disease, valve disease, or an inflamed heart muscle or lining, or who have had a heart attack, congestive heart failure, or recent heart surgery. Atrial fibrillation is quite common following valve surgery and coronary artery bypass (CABG), the incidence of which can range from 5 to 40 percent following coronary artery bypass.

Do monitor afib risk as you age

As you get older, your risk of atrial fibrillation increases. Though age is a risk factor, many people start into atrial fibrillation in their early fifties, hardly old age, and quite a few in their thirties and forties, especially athletes. It is becoming more and more common at younger ages, including young people in their teens and twenties.

Do appreciate the differences between women and men

While men are more likely to develop atrial fibrillation, women are more likely to die prematurely from it. In women 20 to 79 years old, the risk of stroke is 4.6-fold greater than men. In addition, death rates for women with afib are up to 2.5 times greater than for men. Women are also more likely to experience longer symptomatic episodes, more frequent recurrences, and significantly higher ventricular rates during afib.

Do pay attention to potential trigger foods and beverages

Symptoms vary from patient to patient, but some afib sufferers are more sensitive to alcohol or caffeine, such as in coffee or chocolate. Others report that foods containing sugar, flour, or gluten can be triggers.

Do believe you can get your life back

While some of the symptoms of afib can be debilitating, through treatment you can manage your afib. Medications and electrical cardioversion are common for atrial fibrillation treatment, but may not last. With the help of afib specialist, you can have a chance to entirely stop the symptoms and effects of the condition.


Do not delay seeking treatment

The sooner you seek treatment, the better the chance afib can be managed or even stopped. Over time, afib changes the shape and size of the heart, altering the heart’s structure and electrical system. So when someone is left in afib, the ailment may damage the heart, which makes the condition more difficult to treat.

Do not dismiss afib if you don’t have symptoms

While many people have symptoms such as palpitations and lightheadedness, many afib sufferers don’t have any outward symptoms. Afib may be minimized by patients and even doctors because the symptoms aren’t present all the time or, possibly, not at all. Because some health care professionals perceive that afib doesn’t affect patients’ everyday lives, some doctors may allow patients to live with the condition untreated. This can be deadly.

Do not leave sleep apnea untreated

About half of afib patients have obstructive sleep apnea, a stronger correlation than between afib and any other risk factors. There is also a high correlation between sleep apnea and other heart diseases, as sleep apnea is correlated with high levels of C-reactive protein (CRP), a marker of inflammation that indicates the possible presence of heart disease. It’s also possible that afib may cause sleep apnea as well. Afib, obstructive sleep apnea, and obesity all appear to be related conditions, so as we see a surge in obesity, we can expect to see more afib and obstructive sleep apnea, too.

Do not get dehydrated

Under normal conditions, 64 to 80 ounces of water per day is considered enough, but more is needed when weather conditions are dry and dehydrating. In addition to wintertime, this also applies at high altitudes, in the desert, and when you are sweating a lot. Also, drink lots of water (or club soda) during flights to avoid dehydration caused by the very low humidity levels on board. A good rule of thumb: 6 to 12 ounces of water for every hour in the air.

Jumping cartoon

Atrial fibrillation can hijack a person’s life. The heart beats irregularly and can affect everyday living, making even small chores, such as carrying a basket of laundry up the stairs, difficult. Not only that, but afib can have some deadly consequences, such as stroke or heart failure, and can even lead to dementia or Alzheimer’s disease. However, with early detection and treatment by specialists, afib sufferers can lead normal lives. In fact, with the proper treatment, the symptoms – and dangers – of afib can be erased.

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Mellanie True Hills Founder and CEO, and the American Foundation for Women’s Health

Mellanie True Hills, founder and CEO of is now free of atrial fibrillation. She created as part of the American Foundation for Women’s Health to share what she and other atrial fibrillation patients have learned and to ...

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