A heart arrhythmia is an irregular heart rhythm, and the most common type is called atrial fibrillation (Afib). Numbers are rising, and recent studies estimate that 12.1 million people in the United States will have Afib by 2030.
Paul Zei, MD, a Mass General Brigham electrophysiologist, answers the most searched questions about Afib, including its risk factors, symptoms, and treatment. Dr. Zei is director of the Comprehensive Atrial Fibrillation Program at Brigham and Women’s Hospital, where he cares for heart patients.
Your heart has four chambers. In a normal heart rhythm, the chambers beat in sync with each other.
“During Afib, the signals to your heart become disorganized,” explains Dr. Zei. “The heart’s two upper chambers, or atria, beat chaotically and really fast.” The irregular contractions cause the walls of the heart to quiver, or fibrillate. This in turn causes an uneven, rapid heart rate which affects the blood flow through the heart.
“Afib isn’t usually deadly, but it is serious and can cause complications,” Dr. Zei says. It can cause blood clots, which puts you at risk for stroke and heart failure.
Afib is distinct from another related arrhythmia called atrial flutter. In atrial flutter, the atrial chambers beat regularly, but faster and more frequently than the two bottom chambers of the heart, called the ventricles.
The risk factors for Afib include:
Some people with Afib may have no underlying heart problems. The most common causes of Afib are problems with the heart’s structure or other forms of heart disease, including:
Some people don’t experience Afib symptoms, but most feel some of the following:
If you experience Afib symptoms, you should see your primary care provider (PCP). They may refer to you to a cardiologist, such as an electrophysiologist, a special type of cardiologist focused on treating the heart’s electrical system.
“When treating Afib, we take a holistic four-pronged approach,” says Dr. Zei. “We look at the root causes, the symptoms, and also prevention all at once.” Doctors partner with patients to:
“We evaluate the patient’s underlying medical and lifestyle risks,” Dr. Zei says, including family history. It’s important to address underlying conditions like hypertension, obesity, sleep apnea, and diabetes when treating Afib.
If the heart rate is too fast, usually doctors prescribe medication to slow it down. Sometimes doctors also recommend a procedure called an AV junction ablation. This permanently disrupts the electrical signals from atria to the ventricles. Your doctor can implant a device called a pacemaker that sets the heart’s rhythm.
If the heart rate is too slow during Afib, the doctor can use a pacemaker or other device to set the correct speed.
Medication can control the rhythm of the heart. If necessary, doctors perform minimally invasive procedures, including:
Blood thinners help prevent blood clots and the strokes they cause.
Afib can’t always be prevented. But there are some healthy lifestyle habits that may help you lower the risk of heart disease: