A Patient’s Guide to Living With Atrial Fibrillation

Abstract

Atrial fibrillation1 (AF) is the most common heart rhythm disturbance in the United States, affecting over 2 million individuals. Over 150 000 new cases of AF are diagnosed each year. It is estimated that approximately 4% of the population over 65 years of age are affected. The incidence of AF increases with age, so that approximately 11% of individuals over 80 years of age are affected. AF is typically characterized by chaotic, disorganized electrical activity in the upper chambers of the heart. When AF occurs, the upper chambers of the heart (atria) quiver rapidly and irregularly (fibrillate). This chaotic beating can cause a range of symptoms. Although this heart rhythm disturbance is not life-threatening, there is an increased risk of stroke or heart failure for some patients who have AF. A healthcare professional can identify an irregular heartbeat by checking your pulse or listening to your heart with a stethoscope, but an electrocardiogram (ECG or EKG) is the most reliable method to detect and confirm the presence of AF. If the AF comes and goes intermittently (commonly called paroxysmal AF), it may be necessary for you to wear a Holter monitor (a portable ECG monitor) or an event recorder to detect it. AF can cause a range of symptoms. Some people are unaware that their hearts are fibrillating, whereas others are immediately aware of the change in their heart’s rhythm. Symptoms can range from mild fatigue to difficultly breathing, shortness of breath, and palpitations. It is unclear why some people experience symptoms while in AF and others do not. In many patients, the symptoms are related to a rapid heart rate. If medications effectively slow the rate, the symptoms disappear. Other patients continue to have symptoms, even if the heart rate is not fast. Occasionally, symptoms are due to …