Treating a Broken Heart: A Look at Atrial Fibrillation
In recognition of American Heart Month, we wanted to take a moment to look at one of the most common cardiac conditions, atrial fibrillation.
The American Heart Association says more than 2.7 million people in the U.S. are affected by atrial fibrillation – commonly called AFib or AF – making it the most common type of arrhythmia, or irregular heartbeat.
What Is Atrial Fibrillation?
“AFib is an irregular heart rhythm coming from the top chambers of the heart,” said Dr. Anne B. Curtis, vice president of UBMD Physicians’ Group, president and CEO of UBMD Internal Medicine, chair of the Department of Medicine at the Jacobs School of Medicine and Biomedical Sciences, and a world-renowned specialist in clinical cardiac electrophysiology. “Patients may feel symptoms such as palpitations, shortness of breath, and exercise intolerance. AFib is associated with conditions such as hypertension, sleep apnea, obesity and heart failure.”
Hearts have four distinctive chambers – two atria chambers, in the upper part of the heart muscle, and two ventricle chambers in the lower portion. In patients with AFib, the upper chambers fall out of sync – like a drummer that has lost the rhythm – which results in less efficient beating, causing the body to work harder to keep blood flowing properly. This additional strain can have a serious impact on the body.
While many times AFib is asymptomatic, some of the most common signs for patients include shortness of breath or fatigue. A doctor can typically detect heartbeat irregularities during a physical exam, however, and can confirm AFib with additional testing, such as an electrocardiogram (EKG).
AFib Risks and Complications
Over time, persistent and unmanaged AFib can lead to a number of serious cardiac conditions. These include the formation of blood clots, stroke and heart failure. In fact, the AHA reports that untreated, AFib increases an individual’s risk for stroke by a factor of five, while heart-related death risks double.
“Some patients have minimal or no symptoms from AFib,” said Curtis. “However, whether or not a patient is symptomatic, most patients are at an increased risk of stroke because of AFib and at least need treatment with blood thinners to prevent stroke.”
Think of your heart as a ticking clock. Every second, the clock ticks along, keeping time, but if the battery is weak or if the gears are worn, the second hand can begin to fall behind. As it does, the clock no longer tells the right time. This can make you late for a meeting at the office as the seconds the clock is delayed add up, but a heart that continually beats off rhythm falls behind the needs of the body. This can lead to an insufficient amount of blood being pumped to the lungs and the rest of the body’s systems, a condition that can eventually result in heart failure, as the National Heart, Lung and Blood Institute notes.
Living with AFib
While in some cases, the development of AFib is unavoidable, there are a number of lifestyle choices that can help prevent a person from ever having to deal with AFib.
Maintaining a normal weight range, controlling blood pressure, and treating sleep apnea if it is present are a few ways to lower the chances of developing AFib, says Curtis.
If an individual is diagnosed with AFib, however, there’s no better place to turn than UBMD Internal Medicine, a practice within UBMD Physicians’ Group. Curtis has helped write the book on quality of care for AFib – literally. As a member of several American Heart Association guideline committees, she has played an integral part of establishing standards and best practices for care that are used nationwide.
“I was on the guidelines writing committee for the AHA/ACC (American College of Cardiology) for the 2006 guideline, and I stayed on the committee through the 2011 focused updates,” said Curtis. “Through a rigorous process, guideline committees review the evidence from clinical trials and registries to develop evidence-based guidelines for the management of patients with AFib as well as many other conditions.”
One of the most common approaches to AFib treatment includes a regimen of blood thinners. These medications help ease some of the stress on the heart and allow for blood to flow more freely throughout the body. The medication also helps reduce the risk of blood clotting, which can occur if blood pools in the atria – a common complication among atrial fibrillation patients. If the blood forms a clot and circulated into the blood stream, it can cause a stroke, so the medication serves as a vital deterrent.
“We use blood thinners for patients who are at an elevated risk of stroke from AFib,” said Curtis. “Conditions that increase the risk of stroke include hypertension (high blood pressure), heart failure, age greater than or equal to 65 years, diabetes, previous history of stroke or TIA (transient ischemic attack), vascular disease, such as a previous heart attack or peripheral vascular disease, and being female.”
Other treatments include drugs to slow the heart’s rhythm to a more normal rate and antiarrhythmic drugs to try to keep the heart rhythm normal. AFib can also be treated through a procedure known as a catheter ablation.
“Catheter ablation is an invasive procedure to burn or freeze the areas of the heart that allow AFib to perpetuate itself. It can cure the problem,” said Curtis. “The odds of success depend on how long one has had AFib and the size of the chambers where the ablation is done. Longer duration of AFib and dilated heart chambers lower the chances of success.”
Comprehensive Care with UBMD Physicians’ Group
At UBMD Internal Medicine, Curtis and Dr. Hiroko Beck specialize in cardiac electrophysiology, the subspecialty of cardiology that focuses on the treatment of AFib, as well implantable devices like pacemakers and other cardiac treatments. As part of UBMD Physicians’ Group, doctors at UBMD Internal Medicine can work with your family medicine doctor or other specialist, as well, providing a continuous and fluid spectrum of care for all your health needs.
To learn more about the team at UBMD Internal Medicine, or to schedule an appointment with Beck or Curtis, call 716-961-9900.