With proper treatment, individuals with atrial fibrillation can live normal and active lives.

Atrial fibrillation, commonly referred to as AF or a-Fib, is the most commonly occurring arrhythmia, or heart rhythm problem. AF is characterized by an abnormal or irregular heart rhythm that causes a rapid heart rate. The irregular rhythm is due to abnormal electrical impulses in the atria (the upper chambers of the heart) that cause the heart to beat irregularly and too fast.1-4

According to the American Heart Association, an estimated 2.7 million individuals in the United States have AF. The incidence of AF increases with age and occurs commonly in those older than 60 years. Although AF is not considered life threatening, if left untreated it can lead to various complications such as blood clots, stroke, and heart failure. The American Heart Association also reports that more men than women are diagnosed with AF, but women have a greater incidence of stroke-related deaths resulting from AF (Table 1).4

Causes and Symptoms of Atrial Fibrillation
The most common causes of AF include heart abnormalities or damage to the heart structure (Table 2).1-4 Some individuals who have AF are symptom free and the condition may be discovered during a physical examination, but many others experience 1 or more symptoms that vary in frequency and severity. The following are the most common symptoms1-4:
• General feeling of fatigue
• Rapid or irregular heartbeat or palpitations and/or sudden pounding, fluttering, or racing sensation in the chest
• Dizziness
• Lightheadedness
• Anxiety or shortness of breath
• Weakness
• Confusion or faintness
• Sweating
• Chest pain

Diagnosing Atrial Fibrillation
If you have symptoms of AF, you should see your physician for further evaluation. He or she may order an electrocardiogram, a Holter monitor, an echocardiogram, or a blood test to confirm a diagnosis. According to the National Institutes of Health/ National Heart, Lung and Blood Institute, AF may be classified as occasional, persistent, or permanent.2

Treating Atrial Fibrillation
Left untreated, AF can weaken the heart and may eventually cause congestive heart failure and/or a stroke. Your physician will determine the best treatment for you based on the severity of your AF, your symptoms, and the underlying cause. In general, therapeutic goals include controlling heart rhythm and rate, preventing blood clots, and decreasing the risk for stroke. Medications commonly used to treat AF include rhythm control medications (also known as antiarrhythmic drugs), rate control medications, and anticoagulant and antiplatelet medications. According to the National Heart, Lung and Blood Institute, individuals with permanent AF typically require the use of blood thinners to prevent clots.2 If medications are not effective in controlling your AF, your physician may suggest a procedure such as electrocardioversion, catheter ablation, or insertion of a pacemaker.2 Your physician will discuss the potential therapies with you to determine the best option.

Living with Atrial Fibrillation
With proper treatment, individuals with AF can live normal and active lives. It is imperative that you adhere to your prescribed therapy and maintain routine checkups with your physician. You should always discuss with your physician any concerns about your condition or medications and seek immediate medical care if your symptoms worsen. Your physician may also recommend various lifestyle measures to improve your overall health, such as:
• Quitting smoking
• Engaging in routine exercise when appropriate
• Maintaining a healthy weight
• Eating a heart-healthy diet
• Managing blood pressure and cholesterol levels
• Controlling blood glucose levels if you have diabetes
• Eliminating alcohol or reducing consumption to a moderate level
• Reducing stress and practicing relaxation techniques

Other important points to keep in mind if you have AF include the following:
• If you are on blood thinners, always inform your dentist, pharmacist, and other health care professionals that you are taking these medications, and inform your physician of unusual bleeding or bruising.
• Always ask your physician or pharmacist before using any OTC medication, including nutritional supplements and alternative remedies, because some products may contain stimulants that can affect your heart rate or cause serious drug interactions.
• Keep a current list of all medications you take, and bring the list to all checkups.

If you have AF, take a proactive role in your health and talk with your primary health care provider about the available treatments so that you can make informed decisions about your health. A number of educational resources are available for patients with AF (Online Table 3).

TABLE 3: EDUCATIONAL RESOURCES
·         American Heart Association website—Atrial Fibrillation: www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Atrial-Fibrillation-AF-or-AFib_UCM_302027_Article.jsp
·         National Institutes of Health National Heart, Lung and Blood Institute website—What Is Atrial Fibrillation?: www.nhlbi.nih.gov/health/health-topics/topics/af/
·         National Stroke Association website—Preventing a Stroke: http://www.stroke.org/understand-stroke/


Ms Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References:
1. Afib-stroke connection. National Stroke Association website. www.stroke.org/understand-stroke/preventing-stroke/afib-stroke-connection. Accessed November 5, 2014.
2. Who is at risk for atrial fibrillation? National Institutes of Health National Heart, Lung and Blood Institute website. www.nhlbi.nih.gov/health/health-topics/topics/af/atrisk.html. Published September 18, 2014. Accessed November 5, 2014.
3. Atrial fibrillation. Medline Plus website. www.nlm.nih.gov/medlineplus/atrialfibrillation.html#cat5. Reviewed June 25, 2014. Accessed November 5, 2014.
4. FAQs of atrial fibrillation. American Heart Association website. www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_424424.pdf. Accessed November 5, 2014.