Is that pounding or flutter in your chest a harmless phenomenon — or a sign that your heart’s natural rhythm is out of whack?
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Exercise, emotion, caffeine, nicotine and alcohol can all trigger palpitations. But so can atrial fibrillation (AFib), a heart rhythm disorder that causes one in three strokes.
Because its incidence rises with age, everyone 65 and older should be screened for AFib regularly — even if they have no symptoms, says Khaldoun Tarakji, MD, MPH, an expert on heart rhythm disorders, or arrhythmias.
For about 25 percent of patients, a stroke is the first clue that they even have AFib, the most common arrhythmia.
“Some patients with AFib notice symptoms but dismiss them as part of the aging process,” he explains. “Others with AFib feel fine and their lifestyle hasn’t been affected, but we are extremely anxious about them because they are at risk of stroke.”
AFib increases the risk of stroke four- to five-fold. And strokes associated with AFib are more severe, more deadly and cause more disability.
Faulty signaling, varied symptoms
In AFib, due to faulty signals, the top chambers of the heart (atria) don’t contract the way they normally do in regular rhythm. The blood therefore becomes stagnant, and clots can form. If a clot breaks off, it could potentially travel to the brain and cause a stroke.
The symptoms for AFib vary, but typically include:
- Irregular heartbeat
- Chest palpitations, fluttering or pounding
- Extreme fatigue
- Shortness of breath
- Chest discomfort
How to detect AFib
The gold standard for diagnosing AFib is a 12-lead electrocardiogram (ECG), performed at the doctor’s office.
“However, AFib can also be detected by taking your pulse or by wearing blood pressure cuffs, which can often alert you to heart rhythm irregularities,” says Dr. Tarakji. “Most recently, wearable devices using smartphone technologies have become available on the market and can also help detect AFib.”
Any incidents detected can be confirmed through cardiac monitoring, he adds.
Tips on treating AFib
If you are diagnosed with AFib, your doctor will tailor a treatment plan to minimize your personal risks and help you manage your condition.
First-line treatment typically involves:
- Anticoagulants (blood-thinning medication)
- Medications to slow down the heart rate
- Other medications to help maintain normal rhythm
Sometimes, catheter ablation is done to halt the faulty electrical signaling.
“The goals of the management plan are focused on stroke prevention and reducing the impact of AFib on the patient’s well-being and quality of life,” says Dr. Tarakji.
When the risk of AFib rises
The risks of AFib increase when you have hypertension; diabetes; congestive heart failure or other forms of heart disease; obesity; or chronic kidney disease.
While atrial fibrillation can happen at younger ages, it’s uncommon. And after age 65, the stakes are far greater: the risk of stroke with AFib increases with age. If you are older and have additional risk factors, such as hypertension, diabetes or congestive heart failure, your risk increases even more.
“Fortunately, we live in an era where we are equipped with many tools to help us pick up on atrial fibrillation,” Dr. Tarakji says.
His best advice? Be preemptive. Take action now by adopting a healthy lifestyle, losing weight and controlling your blood pressure.
“Simple measures — like checking your pulse or monitoring your blood pressure through home monitoring units or wearable devices — can detect heart rate irregularity, which could be AFib,” he adds. “And talk to your doctor about additional screening and monitoring, when needed.”