Why AFib Matters

What are the consequences of atrial fibrillation (AFib)?


Although atrial fibrillation can feel weird and frightening, an “attack of AFib” usually doesn’t have harmful consequences by itself. The real danger is the increased risk for stroke. Even when symptoms are not noticeable, AFib can increase a person’s risks for stroke and related heart problems.

What causes atrial fibrillation?


Sometimes the cause of AFib is unknown. Other times, it is the result of damage to the heart's electrical system from other conditions, such as longstanding, uncontrolled high blood pressure or artery disease. AFib is also the most common complication after heart surgery.

View an animation of atrialfibrillation.

Usually, the most serious risk from AFib is that it can lead to other medical problems, including:

  • Stroke
  • Heart failure
  • Chronic fatigue
  • Additional heart rhythm problems
  • Inconsistent blood supply


Learn about the important connection between atrial fibrillation, high blood pressure and stroke.

How does AFib lead to stroke?

  • The heart quivers. The upper chambers (the atria) of the heart do not produce an effective, regular contraction.
  • The contraction fails. Imagine wringing out a sponge. Without a good squeeze, water will still be left in the sponge. In the same way, when a heart contraction is either too fast or too uneven, it doesn’t completely squeeze the blood from the atria into the next chamber.
  • Blood pools in the atria. Leftover blood remains in the atria and may pool there.
  • Risks of clotting go up. When blood has the opportunity to pool, it also has the opportunity to clot.
  • Clots can travel and cause blockages. If a blood clot forms in the atria, it can be pumped out of the heart to the brain, blocking off the blood supply to an artery in the brain, causing a stroke. This type of stroke is called an embolic stroke or some doctors call it a cardioembolic stroke.

How does AFib lead to heart failure?


Heart failure means the heart isn’t pumping enough blood to meet the body's needs. AFib can lead to heart failure because:

  • The heart is beating so fast that it never properly fills up with blood to pump out to the body.


As a result, when the heart doesn't efficiently pump the blood forward with strong contractions, symptoms develop because:

  • Blood can “back up" in the pulmonary veins (the vessels that return oxygen-rich blood from the lungs to the heart.) which can cause fluid to back up into the lungs.
  • When AFib causes heart failure, fluid in the lungs can cause fatigue and shortness of breath. Oxygen-rich blood is not being delivered to the body and brain, causing physical and mental fatigue and reduced stamina. Fluid also can build up in the feet, ankles, and legs, causing heart-failure related weight gain.


How does AFib lead to additional heart rhythm problems?


Basic answer: The heart’s electrical system stops working properly, and fails to keep the heart chambers in rhythm.

Thorough answer: Every heartbeat is controlled by the heart’s electrical system. To understand why atrial fibrillation is a problem, it is helpful to understand the normal patterns of the heart’s electrical system.

View an animation of a normal heartbeat.

The heart’s normal electrical pattern:

  • The current travels from top to bottom. The heartbeat starts at the top of the heart and – like an electrical wave – the current travels to the lower parts of the heart, signaling the tissue to contract.
  • The sinoatrial (SA) node starts the contraction in the top of the heart. The right atrium (top section of the heart) houses a group of cells called the sino-atrial node. In healthy adults, the SA node fires off between 60-100 heartbeats per minute. The electrical wave moves through the atria to “gatekeeper node."
  • The atrioventricular (AV) node regulates the timing of the lower portion of the heart. The AV node serves as a "gatekeeper" for all of the electrical pulses going through the atria (top sections) to the ventricles (bottom sections). The electrical pulses are delayed at the AV node before they are allowed to move into the ventricles. The delay gives the ventricles extra time to finish filling with blood before contracting.
  • The ventricles contract and pump blood out to the lungs and the body.

Electrical problems in atrial fibrillation:

  • In AFib, the SA node may not start the contraction. Instead, the contraction might start randomly in other areas of the atria or even in the pulmonary veins.
  • In AFib, the electrical current doesn’t flow in an organized top-to-bottom fashion. Instead, contractions are rapid and disorganized.
  • In AFib, the AV node often can’t regulate the chaotic current. It does its best to protect the ventricle from extra electrical impulses, but it can’t stop all of them. As a consequence, the ventricle beats more often than it should – giving rise to the noticeable symptoms of breathlessness and fatigue.
  • When the beat is off, the blood supply can be unpredictable. So, even though the ventricles may be beating faster than normal, they aren't beating as fast as the atria. Thus, the atria and ventricles no longer beat in a coordinated way. This creates a fast and irregular heart rhythm. In AFib, the ventricles may beat 100 to 175 times a minute, in contrast to the normal rate of 60 to 100 beats a minute.


The amount of blood pumped out of the ventricles to the body is based on the randomness of the atrial beats.

The body may get rapid, small amounts of blood and occasional larger amounts of blood. The amount will depend on how much blood has flowed from the atria to the ventricles with each beat.

Can AFib simply go away?


Yes, rarely "spontaneous remission" does happen; it simply goes away.However, it is still something you and your healthcare provider will want to monitor because some people live with AFib and do not feel the symptoms. However, the risks are still present.

Overall, most of the risks, symptoms and consequences of AFib are related to how fast the heart is beating and how often rhythm disturbances occur.

AFib may be brief, with symptoms that come and go. It is possible to have an atrial fibrillation episode that resolves on its own. Or, the condition may be persistent and require treatment. Sometimes AFib is permanent, and medicines or other treatments can't restore a normal heart rhythm.

But for all the reasons listed above, it is important to work with your healthcare provider to determine your treatment needs, and to understand your treatment options. It is also important to maintain a heart-healthy lifestyle and reduce your overall risks as much as possible.

 

Recent Discussions From The Newly Diagnosed Forum
MJODRH avatar

Hello!  I am 49 years old and a few months ago I was diagnosed with AFib.  About a year and a half ago wore a Zio patch and the results came back as SVT.  My medication was chaged to Hydralazine for HBP and Metropolol.  At first I seemed to respond well but then the palpitations/irregular heartbeat would return.  My meds would be increased and wash, rinse, repeat on the effects.  As my palpitation seemed to get worse, more often and longer, the doctor did another Zio patch.  When the results came back it showed I had Afib and I received like 4 or 5 calls from doctors to work out getting me on an appropriate thinner and to an EP.  My medication was increased again with minimal if any improvement.  This journey I've been on has been very frustrating and scary as it seems no matter the treatment what they episodes just get worse.   What stated as just some random palpiation has turned into episodes every few days that will last for ~12 hours and almost always start in the evening or during the night.  These episodes make me feel tired, anxious, and just overal lethargic.  Also, it increases my urine output and can keep we awake with ongoing trips to the bathroom.  The increased uriniation truly bothers me as as it is dehydrating and I worry about additional stress on my kidney as I am a transplant patient (post transplant 31 years, YAY!).  The kidney transplant also makes antiarthymics not a good choice. 

I don't know where this new Afib journey is going to take me, but I can tell you that the emotional toll is feeling heavy right now.  I hope that by reading about people's experiences will help me to process better and enlighten me with ways to identify triggers and communicate with my cardiologist/EP.

Thanks for reading and thanks for sharing your experiences.

MJ

NOLADan avatar

Hello. I'm 47 years old and was diagnosed with A-Fib just before Thanksgiving. 

I had an ablation Jan 29, and I enjoyed sinus rhythm for 3 days!  A few days later, back to the ER.

Last week I had my first cardioversion and got to enjoy a nice, slow sinus rhythm for 2 days. Today marks my 6th day in Afib without a break. 

I was taking Toporol 50mg 2x a day, Flecainide 150mg 2x a day, and Eliquis 5mg 2x a day.  Now the doctor has stopped my Flecainide and Sunday I start taking 400mg Amiodarone 2x a day.

I've been reading up on Amiodarone, and I have to say I'm scared to start taking it.

Been lurking and reading posts, and just felt the need to vent a little! Thanks

 

chmayer avatar

Had bypass surgery in 2004. Relatively good condition up until now. I was walking frequently and heart rate elevated some (90-110). I would rest for a few minutes and all was fine again. Two weeks before a scheduled Stress Test. I had same elevation to about 105 with normal sinus rythm. During the stress test A-FIB. They said my heart was very strong. Was perscribed Eliquis with directions. I am 77,  BMI is 23, and take numerous suplements. Now I know what Afib feels like. I never had it before the test! Now anytime I do any physical labor or exercise I get afib and it takes about 20 minutes to an hour to recover to normal sinus rythm. My cardoligist was upset that I had been given the stress test.

My question is did (can) a stress test initiate/start afib???  What now? Looks like western medicine is doing its best to hurt me.

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