Improving Your Atrial Fibrillation Prognosis
Healthline
Sept 10, 2021
By Rachel Nall, MSN, CRNA
Medically reviewed by Elaine K. Luo, M.D. in 2019
What is atrial fibrillation?
Atrial fibrillation (AFib) is a heart condition that causes the upper chambers of the heart (known as the atria) to quiver.
This quivering prevents the heart from pumping effectively. Normally, blood travels from an atrium to the ventricle (lower chamber of the heart), where it’s pumped either to the lungs or to the rest of the body.
When the atrium quivers instead of pumping, a person can feel like their heart has flip flopped or skipped a beat. The heart may beat very rapidly. They may feel nauseous, short of breath, and weak.
In addition to the heart sensations and palpitations that can come with AFib, people are at greater risk for blood clots. When the blood doesn’t pump as well, the blood that stalls in the heart is more prone to clot.
Clots are dangerous because they can cause stroke. According to the American Heart Foundation, an estimated 15 to 20 percent of people who have a stroke also have AFib.
Medications and other treatments are available for those with AFib. Most will control, not cure, the condition. Having AFib can also increase a person’s risk for heart failure.
Your doctor may recommend a cardiologist if he or she thinks you may have AFib.
What’s the prognosis for a person with AFib?
According to Johns Hopkins Medicine, an estimated 2.7 million Americans have AFib. As many as one-fifth of all people who have a stroke also have AFib.
Most people ages 65 and older who have AFib also take blood-thinning medications to reduce the likelihood of complications like stroke. This improves overall prognosis for people with AFib.
Seeking treatment and maintaining regular visits with your doctor can typically improve your prognosis when you have AFib.
According to the American Heart Association (AHA), 35 percent of people who don’t receive treatment for AFib go on to have a stroke.
The AHA notes that an episode of AFib rarely causes death. However, these episodes can contribute to you experiencing other complications, such as stroke and heart failure, that can lead to death.
In short, it’s possible for AFib to affect your lifespan. It represents a dysfunction in the heart that must be addressed. However, many treatments are available that can help you control your symptoms and reduce your risk for major events, such as stroke and heart failure.
What complications can occur with AFib?
The two primary complications associated with AFib are stroke and heart failure. The increased risk for blood clotting could result in a clot breaking off from your heart and traveling to your brain. The risk for stroke is higher if you have the following risk factors:
- diabetes
- heart failure
- high blood pressure
- history of stroke
If you have AFib, talk to your doctor about your individual risk for stroke and any steps you could take to prevent one from occurring.
Heart failure is another more common complication associated with AFib. Your quivering heartbeat and your heart not beating in its normal timed rhythm can cause your heart to have to work harder to pump blood more effectively.
Over time, this can result in heart failure. This means your heart has difficulty circulating enough blood to meet your body’s needs.
How is AFib treated?
Many treatments are available for AFib, ranging from oral medications to surgery. First, it’s important to determine what’s causing your AFib.
For example, conditions like sleep apnea or thyroid disorders can cause AFib. If your doctor can prescribe treatments to correct the underlying disorder, your AFib may go away as a result.
Medications
Your doctor may prescribe medications that help the heart maintain a normal heart rate and rhythm. Examples include:
- amiodarone (Cordarone)
- digoxin (Lanoxin)
- dofetilide (Tikosyn)
- propafenone (Rythmol)
- sotalol (Betapace)
Your doctor may also prescribe blood-thinning medications to reduce your risk of developing a clot that could cause a stroke. Examples of these medications include:
- apixaban (Eliquis)
- dabigatran (Pradaxa)
- rivaroxaban (Xarelto)
- edoxaban (Savaysa)
- warfarin (Coumadin)
The first four medications listed above are also known as non-vitamin K oral anticoagulants (NOACs). NOACs are now recommended over warfarin unless you have moderate to severe mitral stenosis or an artificial heart valve.
You doctor may prescribe medications to ideally cardiovert your heart (restore your heart to normal rhythm). Some of these medications are administered intravenously, while others are taken by mouth.
If your heart starts beating very rapidly, your doctor may admit you to the hospital until the medications are able to stabilize your heart rate.
Cardioversion
The cause of your AFib may be unknown or related to conditions that directly weaken the heart. If you’re healthy enough, your doctor may recommend a procedure called electrical cardioversion. This involves delivering an electric shock to your heart to reset its rhythm.
During this procedure, you’re given sedative medications, so you most likely won’t be aware of the shock.
In certain instances, your doctor will prescribe blood-thinning medications or perform a procedure called a transesophageal echocardiogram (TEE) before cardioversion to ensure there aren’t any blood clots in your heart that could lead to stroke.
Surgical procedures
If cardioversion or taking medications doesn’t control your AFib, your doctor may recommend other procedures. They may include a catheter ablation, where a catheter is threaded through an artery in the wrist or groin.
The catheter can be directed toward areas of your heart that are disturbing electrical activity. Your doctor can ablate, or destroy, the small area of tissue that’s causing the irregular signals.
Another procedure called the maze procedure can be performed in conjunction with open-heart surgery, such as a heart bypass or valve replacement. This procedure involves creating scar tissue in the heart so irregular electrical impulses can’t transmit.
You may also require a pacemaker to help your heart stay in rhythm. Your doctors may implant a pacemaker after an AV node ablation. The
AV node is the heart’s main pacemaker, but it can transmit irregular signals when you have AFib.
Your doctor will create scar tissue where the AV node is located to prevent irregular signals from being transmitted. He will then implant the pacemaker to transmit the correct heart-rhythm signals.
How can you prevent AFib?
Practicing a heart-healthy lifestyle is vital when you have AFib. Conditions like high blood pressure and heart disease can increase your risk for AFib. By protecting your heart, you may be able to prevent the condition from occurring.
Examples of steps you can take to prevent AFib include:
- Stopping smoking.
- Eating a heart-healthy diet that’s low in saturated fat, salt, cholesterol, and trans fats.
- Eating foods that are high in nutrients, including whole grains, vegetables, fruits, and low-fat dairy and protein sources.
- Engaging in regular physical activity that helps you maintain a healthy weight for your size and frame.
- Losing weight is recommended if you are currently overweight.
- Getting your blood pressure checked regularly and seeing a doctor if it’s higher than 140/90.
- Avoiding foods and activities that are known to trigger your AFib. Examples include drinking alcohol and caffeine and engaging in intense exercise.
It’s possible to follow all these steps and not prevent AFib. However, a healthy lifestyle will enhance your overall health and prognosis if you have AFib.