Atrial Fibrillation – What it is, its Symptoms and its Treatments

Co-authored by Cameron Towle (Cardiac Nurse) & Kerry James (Kinesiologist)

This blog is for informational and entertainment purposes and is not intended to diagnose or treat any medical condition; for more information, please consult with a trusted health professional.

Have you recently been diagnosed with atrial fibrillation, more commonly referred to as Afib? You’re not alone; the Heart & Stroke foundation reported 200,000 Canadians living with Afib in 2020. Atrial fibrillation is the most common form of heart arrhythmia. An arrhythmia is when the heart beats too quickly, too slowly or irregularly.

What is Afib?
More specifically, Atrial fibrillation is when the atria (or the upper portions of the heart that fill with blood) do not beat in their usual organized fashion, causing the heart to be less efficient in sending oxygen rich blood to the body. This inefficient movement of the atria can be temporary, a standalone event, or something that you and your health care team will treat and control long-term. Check out this animation by the CDC to see Afib in action.

There are three types of Atrial Fibrillation:

• Paroxysmal: These are transient episodes that come on suddenly and then often resolve within 24 hours (could last up to 7 days)
• Persistent: A little more stubborn, these episodes will last more than 7 days and may require medical assistance to get the heart back to its normal rhythm
• Permanent: These episodes are described as lasting more than a year and may or may not be responsive to treatment. Some individuals with permanent afib do not experience symptoms or require medical intervention

What are some of the Risk Factors for Atrial Fibrillation?
Non modifiable risk factors for Atrial Fibrillation include advancing age, European descent, diabetes, heart failure, heart disease, kidney disease and hyperthyroidism.

As for what we can control, modifiable risk factors include:

• Obesity
• Smoking
• Sedentary lifestyle
• Alcohol use
• High blood pressure

In some cases, the cause of Atrial fibrillation is unknown, but a healthy and balanced lifestyle will reduce risk factors for Afib as well as other chronic conditions, cardiac and otherwise.

What does Atrial Fibrillation feel like?
Atrial Fibrillation can manifest differently in everyone. In fact, some people may never experience symptoms! Common symptoms may include:

• Heart palpitations, as though your heart is beating irregularly
• Weakness or feeling more exhausted than usual
• Chest pain
• Dizziness
• Sweatiness
• Anxiety or difficulty focusing

Feeling any of the above or any symptoms including chest pain, jaw pain, heaviness in the chest, nausea or anxiety? Call 911 immediately to seek medical care.

Diagnosing Atrial Fibrillation
Should your doctor suspect Afib, they may seek a diagnosis using any of the following:

• Electrocardiograms (ECG)
• Exercise Stress Tests
• Holter Monitor

Often they may order other tests including an echocardiogram and blood tests.

How is Afib Treated?
After a diagnosis of Atrial Fibrillation has been made, you and your doctor will decide the best route to treat and manage your symptoms. Treatment options can include medications to control risk factors, anticoagulation to “thin the blood” and prevent strokes (more on that later), controlling heart rate or controlling heart rhythm.

• Anticoagulants such as warfarin (Coumadin™), apixaban (Eliquis™), rivaroxaban (Xarelto™), dabigatran (Pradaxa™)
• Medications to slow the heart rate (not necessarily convert you to a normal rhythm
  • Beta Blockers such as metoprolol or bisoprolol
  • Calcium Channel Blockers such as diltiazem or verapamil
• Antiarrhythmic medications to keep you in normal rhythm such as:
  • Sotalol, amiodarone, dronedarone (Multaq™), flecainide, propafenone (Rhythmol™)

Other Treatment Options for Afib
In some instances, you may be referred to an Electrophysiologist who is a cardiologist specialized in the electrical portion of your heart. They may recommend a procedure called an ablation. This is where they use a catheter to go through a vein and into your heart. They then either freeze or burn an area in your heart muscle in order to create scars to block the irregular electrical pathways that cause Afib. As a last resort, they may recommend a pacemaker insertion in addition to an ablation to control Afib.

Atrial Fibrillation and Stroke
Atrial Fibrillation is associated with an increased risk of Stroke. This increased risk for stroke is caused by blood pooling in the left atrium of the heart due to the heart’s ineffective contractions. As blood pools and has time to “sit still” there is an increased risk of clot formation. If a clot is ejected from the heart, it could travel to the brain and become lodged in a small blood vessel which may completely block blood flow and cause a Stroke.

The Takeaway
A diagnosis of Afib can be scary and overwhelming, but the condition is treatable and manageable! With the help of your medical team, a balanced lifestyle and cardiac rehab; you can manage your condition and still do all the activities you enjoy.

Sources cited:

Centers for Disease Control and Prevention. (2020, September 8). Atrial Fibrillation. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/atrial_fibrillation.htm.
Surgical Procedures for Atrial Fibrillation (AFib or AF). www.heart.org. (n.d.). https://www.heart.org/en/health-topics/atrial-fibrillation/treatment-and-prevention-of-atrial-fibrillation/surgical-procedures-for-atrial-fibrillation-afib-or-af.