With diagnoses expected to double over the next six years, atrial fibrillation is becoming an increasingly prominent public health issue.
Today, more than 5 million Americans have atrial fibrillation, often called AFib. That number is projected to increase to 12 million by 2030. As we mark National AFib Awareness Month this September, we take a closer look at this common condition and examine the uptick in cases.
Defining AFib
With AFib, the heart’s upper chambers (atria) beat irregularly and often rapidly. This erratic rhythm disrupts the normal flow of blood through the heart. While AFib often is associated with a rapid heartbeat, it can also lead to a slow heart rate. The irregular heartbeat in turn leads to other symptoms and increases the risk of severe complications.
Explaining the Uptick
According to the American Heart Association, an aging population is the primary driver of the increase in AFib diagnoses.
“Age is a major risk factor of atrial fibrillation, contributing to the prevalence and incidence of AFib,” says Dr. Babar Parvez, Clinical Cardiac Electrophysiologist and Medical Director of Cardiovascular and Heart Rhythm Services with ThedaCare Cardiovascular Care.
Chronic health issues also contribute to the rise in people living with an irregular heartbeat. Diabetes, hypertension, endocrine issues, malignancies, nutritional deficiencies, and medicines all play a major role in an ever-increasing incidence of AFib, Dr. Parvez says.
In addition, the COVID-19 pandemic has led to an increase. Research shows new-onset AFib was common among patients hospitalized with COVID-19 (half of them dying while hospitalized). More than 5% of patients studied were diagnosed with AFib.
“Any infection, mild or severe, can lead to a higher incidence of AFib, especially if the patient is sick enough to be hospitalized because of septic shock and respiratory issues,” Dr. Parvez says.
“This exponentially increases the risk of atrial fibrillation, given the overall inflammatory state and cardiac demand.”
An increased awareness of AFib and improvement in diagnostic capabilities also have led to uncovering more cases. Wearable devices such as smartwatches continue to become more sophisticated. Many can detect AFib but not diagnose it, Dr. Parvez says. Nevertheless, they’re an important tool.
Symptoms
Some individuals may not detect any AFib symptoms, while others may have noticeable and uncomfortable signs.
- Chest pain: Discomfort or pain in the chest, which requires immediate medical attention.
- Palpitations: A sensation of a racing, fluttering, or irregular heartbeat.
- Fatigue: Persistent tiredness and lack of energy.
- Shortness of breath: Difficulty breathing, especially during physical exertion.
- Dizziness or lightheadedness: Feeling faint or experiencing vertigo.
Risk Factors
Several factors can increase the likelihood of developing AFib.
- Age: Especially after age 60.
- Heart disease: Individuals with a history of hypertension, heart failure, or coronary artery disease.
- Other chronic conditions: Diabetes, thyroid disorders, and sleep apnea.
- Lifestyle factors: High alcohol consumption, heavy caffeine use, tobacco use, obesity, stress, and sedentary lifestyles.
- Family history: A genetic predisposition can play a role.
Complications
AFib can lead to severe complications if left untreated.
- Stroke: The erratic heartbeat can cause blood clots to form in the atria. These may travel to the brain and result in a stroke. AFib increases stroke risk by approximately five times.
- Heart failure: Inefficient blood flow and the heart’s inability to pump effectively can lead to heart failure.
- Other complications: Chronic AFib also can contribute to additional cardiac issues, such as cardiomyopathy and an overall decline in heart function.
Treatment Options
Treatment for AFib aims to restore normal heart rhythm and prevent complications. Your cardiovascular care specialist will help you determine the best treatments for your unique needs.
- Medications: Anticoagulants (blood thinners) reduce stroke risk, while antiarrhythmic drugs help maintain a regular heartbeat. Beta-blockers and calcium channel blockers manage heart rate.
- Cardioversion: This procedure uses electrical shocks or medication to reset the heart’s rhythm.
- Catheter ablation: A procedure that involves using energy, either through heat or freezing, to eliminate (ablate) the areas of heart muscle that are causing the heart to beat irregularly.
- Lifestyle modifications: Managing underlying conditions, maintaining a healthy weight, and avoiding alcohol and caffeine can help control AFib.
- Surgical options: In severe cases, surgical interventions might be necessary.
Prevention
Preventive measures can significantly reduce the risk of developing AFib.
- Healthy lifestyle: It’s critical to get regular exercise, eat a balanced diet, refrain from smoking, and avoid excessive alcohol consumption.
- Managing chronic conditions: Keeping hypertension, diabetes, sleep apnea, and other chronic illnesses under control can lower AFib risk.
- Regular medical checkups: Routine monitoring and early intervention can prevent the onset of AFib or detect it in its early stages. If you’re due for a wellness visit, schedule now.
“Reversing the growing AFib trend will require further public awareness and at least a generation or two of changing to more favorable dietary habits,” Dr. Parvez says. “Also, researchers need to better understand the genetic contribution to atrial fibrillation, and the correlation of little exercise and poor lifestyles with the onset of AFib.”
