Lowering Your Risk of Atrial Fibrillation After Heart Surgery

Days into recovery from heart surgery, an odd feeling may hit your chest. Your once steady heartbeat — lub-dub, lub-dub, lub-dub — might suddenly switch to the chaotic rhythm of an elementary school band.

This erratic and irregular heartbeat is called atrial fibrillation, or AFib. It’s a common and frightening symptom affecting up to 55% of patients after cardiac surgery, according to some estimates.

So, is there a way to reduce your risk of developing AFib and the complications that can come with it? Let’s look at options with cardiothoracic surgeon Edward Soltesz, MD.

Why does AFib often follow heart surgery?

It’s believed that inflammation in the chest following heart surgery contributes to AFib within a week after the procedure, says Dr. Soltesz. But the exact trigger for AFib remains unclear.

AFib is basically a malfunction of your heart’s electrical system, which powers the steady contractions that pump blood through your body. Most people’s heart rates are between 60 and 100 beats per minute. But AFib brings a series of rapid, chaotic pulses that upset your heart’s rhythm and drive it higher or lower. When this happens, your heart doesn’t contract effectively — which means blood isn’t squeezed out properly.

Some cases of AFib can be mild enough to go unnoticed. More severe cases of AFib, however, can lead to fatigue, chest pains (angina) and what’s described as a “feeling of butterflies” in your chest.

How to lower your risk of AFib

“Prevent” may be too strong a word regarding your ability to ward off the development of AFib, but here are four steps you can take ahead of heart surgery to reduce your risk, according to Dr. Soltesz:

1. Focus on diet and exercise. A healthier heart going into surgery decreases your chance of experiencing AFib afterward. Work with your healthcare provider to create a “heart-healthy” eating and exercise plan to get you ready for the rigors ahead.
2. Address other health issues. Your risk of AFib increases if you go into surgery with anemia (low iron levels in the blood), an electrolyte imbalance or high blood sugar. Your doctor may perform tests before the procedure to check for these issues, which often can be addressed through a changed diet or by taking medication or vitamins.
3. Stop smoking and limit alcohol. Need another reason to stop smoking if you’re currently lighting up? Consider this: Smoking increases your risk of AFib by 32%, according to researchers. Quitting can improve your odds. Excessive alcohol intake also can increase the risk of AFib.
4. Limit stress. The relationship between stress and AFib is still being explored, but there appears to be a connection. Managing stress and anxiety can minimize your cardiovascular risk.

Is AFib treatable?

If you get AFib, various treatments and medications are available to help get your heart back into its proper rhythm.

Regaining control is important. Untreated AFib can increase your risk of blood clots and stroke. (Fast fact: AFib causes about 1 in 7 strokes, according to the U.S. Centers for Disease Control and Prevention.)

Over time, AFib can weaken your heart and open the door to heartfailure.

“AFib can occur sporadically or persistently — and if it happens once, it’s more likely to happen again,” states Dr. Soltesz. “Talk to your physician before and after surgery about your potential risks and what you can do to decrease them.”