It is a condition of increasing frequency and becoming a significant issue as the population continues to age: atrial fibrillation (AFib).
What is it?
Atrial fibrillation is commonly referred to as ‘fibro’ or ‘electrolyte imbalance’, and is a condition where the normal rhythm of the heart is disrupted. In most cases, fibro develops as a result of abnormal heart muscle or heart valve function. It can also be the result of an abnormal electrical conduction system in the heart.
Fibro is often considered to be an ‘ageing heart disease’ due to its increasing incidence with age. Statistics show that one in four people over the age of 80 suffer from the condition. It is more common in men than in women. While the risk factors for developing fibro are not well researched, there are some established risk factors:
- genetics – it is often considered to be genetically determined
- diabetes – diabetes has a well-known association with heart disease, and it has recently been suggested that it may also be a risk factor for developing fibro
- obesity – being overweight or obese increases your risk of developing heart disease, and it has been suggested that it may also be responsible for the development of fibro
- smoking – both active and passive smoking have been shown to increase the risk of developing heart disease, and they have also both been linked to the development of fibro
- poor diet – diet plays an essential role in maintaining good heart health, and a diet consisting of plenty of fruit and vegetables has been shown to significantly reduce the risk of developing heart disease.
What is the effect of AFib on the body?
When there is an irregular heartbeat, there is often a corresponding pulse in the groin or neck, and this can be felt as well as seen on an ECG. However, there is no specific symptom which indicates that you have fibro, and in many cases, the condition is not even suspected until the patient experiences symptoms such as dizziness, chest pain or shortness of breath.
In addition to these symptoms, patients with fibro often display symptoms associated with heart failure (e.g. swelling around the ankles, rapid weight gain, and poor appetite). Patients with AFib often need to take pills or supplements to keep their heart rhythm regular, as well as medications to treat the underlying causes of the condition.
What are the common causes of AFib?
As mentioned above, the majority of cases of AFib are due to problems with the heart muscle or the valves which control the flow of blood in the heart. The most common cause of AFib is age, with the condition affecting people of all ages, but it is most prevalent among those aged 60 and over. However, in some cases, the condition can occur as a result of heart disease which is present at birth (i.e. congenital) or develop later in life (i.e. acquired).
The most common cause of acquired AFib is valve dysfunction due to rheumatic fever or degenerative valve disease. The other common causes of AVFib are hypertension, mitral valve prolapse, and endocarditis (i.e. an infection of the heart valves). The two most common causes of AFib in infants are valvular heart disease and congenital heart disease. In some cases, AFib can be caused by a thyroid problem or a hyper-active adrenal gland. In these cases, it may be difficult to treat.
How is AFibmanaged?
The first step in managing AFib is to make a proper diagnosis. This can be challenging, as many of the symptoms of AFib are very similar to those of other disease conditions. In particular, many of the symptoms associated with heart failure (e.g. shortness of breath) are very similar to those of COPD (i.e. chronic obstructive pulmonary disease). As a result, many of the cases of AFib are misdiagnosed or go unidentified. In some cases, patients with AFib are even referred to as ‘sick sinuses’ or ‘sick hearts’ (since they often experience similar symptoms to patients with chronic sinusitis or strep throat).
Once the diagnosis is confirmed, the next step is to determine the underlying cause. In many cases, it is not possible to determine exactly what caused AFib, and the condition is therefore classified as ‘idiopathic’ (i.e. of unknown cause). In these cases, the most common and most effective treatment is to maintain a healthy weight, restrict the intake of salt, and manage any other risk factors for heart disease (e.g. high blood pressure). In some cases, particularly in those where the onset of the condition is rapid, it may be necessary to investigate further. In these cases, it is usual to perform an EKG to check for electrical abnormalities, an echo-cardiogram to check for structural abnormalities, or a cardiac MRI to check for possible damage to the heart muscle (myocardial infarction – MI). However, in many cases, particularly in those where the onset of the condition is slow, it is not possible to determine the exact cause of the condition, and it is simply referred to as ‘senile’ or ‘wear and tear’ (since it tends to affect those who are more senior in years). In these cases, patients are generally advised to manage the symptoms as best they can and not to worry about the cause.
Is it reversible?
In many cases, the underlying causes of AFib are easily determined and the condition is therefore considered to be ‘reversible’. This means that, in many cases, the patient can simply undergo treatment to eliminate or reduce their symptoms and the condition will then resolve itself. However, in some cases, particularly in those where the cause is not known or in cases of rapid AFib where the heart is not functioning at its optimum capacity, reversing the condition may be difficult or even impossible. In these cases, it is simply referred to as ‘unreversible’ or ‘end-stage’ (since the patient will inevitably die). In general, it is best to try and prevent AFib through healthy living and by treating any underlying causes before the condition develops, as this will make the condition easier to manage when it does occur.
What are the side effects of AFib?
In addition to the symptoms described above, there are a number of potential side effects associated with AFib. These include: