Frequently Asked Questions

How did I get AFib?

Some possible risk factors for AFib are: advanced age, another underlying abnormal heart condition, high blood pressure, excessive alcohol drinking, sleep apnea, and/or other chronic medical problems. Some studies support the theory of heredity.

Can a person be cured of this? Can it go away?

Yes. One form of atrial fibrillation that is treatable is so-called paroxysmal atrial fibrillation. This form of atrial fibrillation is more common in younger people and in people without serious underlying structural heart disease. In fact, this form of atrial fibrillation often occurs without any other underlying heart disease present. This paroxysmal form occurs when episodes of atrial fibrillation come for a short period of time and go away suddenly, only to return later. This form is often associated with frequent extra beats in the atrium.

Is atrial fibrillation associated with a heart attack or a stroke?

Atrial fibrillation is a very rapid irregular rhythm in the top two chambers of the heart. A heart attack is when an artery supplying blood to the heart blocks off causing damage to the heart muscle. A stroke occurs when an area of the brain does not get enough blood supply, in some cases due to a blocked artery supplying blood to the brain. This leads to brain damage and neurologic dysfunction.

Atrial fibrillation can be associated with a heart attack or a stroke. Atrial fibrillation is a common cause of stroke in the elderly and up to 30 percent of the strokes in individuals over the age of 75 are due to atrial fibrillation. The reason that atrial fibrillation can be associated with, or cause, a stroke is because blood clots tend to form in the upper chambers, so-called atria, of the heart and these blood clots can break off and travel throughout the body, plugging up blood vessels. It can also travel to the heart and clog up a vessel creating a heart attack or it can travel to any other area of the body causing a blocking in an artery--to the leg, for example, in the eye or any other organ. The risk of blood clots caused by atrial fibrillation increases in the following conditions:  hypertension, heart failure, diabetes, increasing age.

Is it true that some people have no symptoms until they have a stroke?

Yes, it can be true for some people. For some people, atrial fibrillation represents no more than a new, annoying palpitation. For other people, it can be the cause for a stroke but the process might have been unrecognized until that point. The older you are, and the more risk factors you have for stroke, the greater the chance that without being on a blood thinner, that atrial fibrillation will cause a stroke. One issue about atrial fibrillation is that there are those that have it and do not even recognize that it is present. Stroke can be caused by atrial fibrillation even in younger individuals and it is one of the potential causes for stroke in which no obvious cause can be diagnosed.

Now that I have atrial fibrillation, what do I do next? When do I see my doctor?

As soon as you notice the symptoms of AFib (heart fluttering or pounding, fainting or dizziness, shortness of breath, fatigue, anxiety), you need to contact your physician. Even if your symptoms go away, you still need to have a physical exam.

What is the difference between a cardiologist and an electrophysiologist?

An electrophysiologist is a cardiologist that specializes in the study of the electrical activities of the heart. They have completed two more years of fellowship beyond a general cardiology fellowship. They are trained to perform interventional cardiac electrophysiology studies and surgical device implantations.

What medicines will I be on and how do they work?

Medication is most often prescribed to control heart rate and rhythm. It is also prescribed to prevent or treat current blood clots. You could be on medicine from other underlying conditions. Your doctor will need to know the current meds you are taking so your new meds will not interfere. Some medications your doctor might prescribe for you are:

  • Beta blockers – these are used to slow the heart rate and widen vessels to increase blood flow
  • Calcium channel blockers – these are also used to slow the heart rate and widen vessels to increase blood flow
  • Digoxin – this medication slows the rate at which electrical currents are conducted from the atria to the ventricle
  • Blood thinners – drugs such as these are given to patients to reduce the risk for blood clot formation or to treat an existing blood clot.

Is it safe to exercise with this condition?

In general, it is not a good idea to work out too vigorously with atrial fibrillation unless you have been carefully evaluated for underlying heart conditions by a doctor. Some people who have atrial fibrillation have significant problems with their heart and with exercise, the heart rate can race tremendously during atrial fibrillation, thereby exacerbating the underlying heart condition and may lead to problems such as very low blood pressure, heart failure or a loss of consciousness. If the problem of atrial fibrillation has been well managed so that the rate is under control, or the rhythm is under control, it is possible to go back to standard physical activity in many cases.

Should I wear a medical alert bracelet or carry a card in my wallet?

In any emergency situation, having a patient’s medical history is very helpful. Be sure and write down the medication that you are taking and the dose.

Can over-the-counter drugs cause irregular heartbeats? Do symptoms go away when the use of the OTC is discontinued? Or can you cause permanent damage?

Some over-the-counter drugs can cause irregular heartbeat and some OTC drugs can be associated with atrial fibrillation. The ones of concern are the ones that include adrenalin analogs. Adrenalin is made in the body and it increases the heart rate and blood pressure. Pseudoephedrine is one such compound. This is present in many cold and decongestant preparations. If an irregular rhythm, or atrial fibrillation, is triggered by an OTC preparation, it may persist for some period of time. But generally, it goes away on its own but if it does not, it can cause permanent damage to the heart over time.

Can I tell when I’m going to have an episode of AFib?

Most of the time, no, but you can control your “triggers”. In some people, different things cause their AFib to flare up. Caffeine, alcohol, stress, getting up in the middle of the night after being fully asleep, eating MSG, the heart rate increase that occurs during exercise…these are all common “triggers” that might lead to an episode.

Are there any underlying conditions that make a person more prone to an irregular heartbeat?

Yes. While an irregular heartbeat can occur independent of any other heart condition, it is worth having the problem checked out because an irregular heart rhythm may be a sign of a concerning underlying heart condition such as cardiomyopathy, heart failure, coronary artery disease, valvular heart disease and other similar conditions.

I have occasional (Paroxysmal) AFib. I've heard that AFib is a progressive disease that only gets worse. What are my chances of getting permanent (Chronic) AFib?

Afib is a progressive disease, but you won't necessarily go into permanent (Chronic) AFib. In AFib your heart has a tendency to remodel itself both physically and electrically. Studies have shown that sometimes these effects can be reversed, but in other situations this may not be possible.