By Crystal McGough, Editor
The month of September offers a good reminder to those over 50 that it may be a good time to visit your general practitioner and get your heart checked. While February is more commonly known for being National Heart Month, September is officially the month for promoting Atrial Fibrillation (AFib) Awareness.
Atrial Fibrillation is an abnormal heart rhythm that comes from the top chambers of the heart. According to Dr. John Parks, and interventional cardiology specialist with Ascension St. Vincent’s, AFib is probably the most common abnormal heart rhythm in the U.S. in adults.
“AFib is an increasing problem in the U.S.,” Parks said. “There are about three million people in the United States that have AFib.”
Parks described AFib as an irregular heart rhythm where the heart beats fast and skips around a lot.
“People might notice this if they have symptoms of palpitation such as racing or skipping in their chest, but it tends to be a very fast heart rate (around 120),” he said. “It tends to be something that happens in older folks, particularly in folks above the age of 65.”
While AFib in young people is considered rare, it can occasionally be diagnosed in younger people who have congenital heart disease due to being born with a heart defect.
In general, however, Dr. Parks said he would recommend people over age 50 have an EKG at least once every three to five years with their primary care doctor, just to look for potential issues.
Untreated AFib can result in complications such as blood clots or even strokes.
“That’s why we’re trying to bring awareness, so we can decrease risks for folks,” Parks said.
“Generally, people have symptoms with AFib – they end up coming to the emergency room because it tends to make them have symptoms of shortness of breath or chest pain. But occasionally, people will come in with AFib that don’t realize (they have it) – so not everyone has symptoms with AFib – and they’ll come in presenting with a blood clot or a stroke, and that comes with that rhythm problem.”
Blood clots happen with AFib when the heart beats so fast and irregularly that blood flow gets stagnant inside a small area inside of the heart, Parks said. A blood clot then forms in the heart and can move outside of the heart.
“If it goes to the brain, it typically causes a stroke and, unfortunately, they tend to be large strokes,” Parks said.
AFib is usually diagnosed by an EKG or heart-rhythm tracing, either in the doctor’s office or in the emergency room.
“That’s the easiest way to diagnose it for sure,” Parks said. “There are some newer phone apps (such as the Kardia app) and things like Apple watches that can sometimes pick up abnormal heart rhythms that can be clues that something is going on.”
If this happens, he says people should be checked out by their primary care doctor or a cardiologist.
While AFib can cause other health problems like blood clots and strokes, it can also be caused by pre-existing health conditions.
“People that have had heart problems in the past like coronary artery disease or high blood pressure, those are things that can cause people to have AFib,” Parks said. “Sleep apnea and other stressors can cause AFib, as well.”
AFib is typically treated with blood thinners and medications that help keep the heart rate down, but unfortunately, blood thinners aren’t an option for everyone.
“As I mentioned, AFib comes with a risk of blood clots that can cause a stroke, but we have a number of patients, for various reasons, that can’t take blood thinners to prevent those blood clots,” Parks said. “So, an alternative has been for us to do this minimally invasive procedure (called Watchman) that’s done through the leg vein where we place an implant into the upper left chamber of the heart where blood clots tend to form – in an area of the chamber called the appendage – and we seal off this area with a small, flexible implant that prevents blood clots with AFib from forming. So, we kind of stop the blood clots before they ever have a chance to form, and we can prevent strokes with an implant rather than having to take a blood thinner if they have a high risk of bleeding issues.”
Another option for people who have problems with medication is an AFib ablation, a minimally invasive procedure that’s done through the leg vein where catheters are placed into the heart and the electrical system is mapped to identify where the AFib is coming from. Physicians then use small amounts of electrical energy to cause those areas to get rid of the excitable heart cells that are causing the AFib. More rarely, a patient may need to be treated with a pacemaker.
Dr. Parks said there are preventative measures people can take to prevent AFib, such as keeping their blood pressure under control and maintaining a healthy weight, including losing weight if necessary.
“There’s also some evidence that eating a Mediterranean diet with plenty of fresh fruits and veggies and healthy fats can reduce the risk of heart rhythm problems,” Parks said.
He also recommended that people over the age of 50 be on the lookout for health fairs, which are occasionally held at local churches or community gathering places, where health professionals offer screening physicals and free routine EKGs.
“We don’t have anything scheduled right now, but people can be on the lookout for those screening events,” he said. “It’s always good for people to have a close relationship with their primary care doctor, as well.”