Weighing In The Evidence: Lifestyle Modification In The Treatment Of Atrial Fibrillation

Abstract

Imagine if you suddenly felt your heart “jumping out of your chest” – this is the case for an estimated 1 in 4 Canadians who experience this rapid and chaotic heartbeat characteristic of atrial brillation (AF). The healthy heart works continuously to beat regularly under the control of electrical impulses originating from the sinoatrial (SA) node, the heart’s natural pacemaker. In AF, electrical impulses do not originate in the SA node, but rather, from a different part of the atrium or in nearby pulmonary veins. These abnormal electrical signals become rapid and disorganized, radiating throughout the atrial walls in an uncoordinated manner. This can cause the walls of the atrium to quiver, or brillate, which results in irregular electrical transmission from the atria to the ventricles. A normal heart rate at rest should be between 60-100 beats per minute at rest, but in AF, it can be considerably higher than 140 beats per minute1. Affecting more than 33 million individuals worldwide, AF is the most common sustained irregular heart rhythm encountered in clinical practice2. The progression and maintenance of AF results in adverse events, including an increase in hospitalizations and a ve-fold increase in the risk of stroke3. Given this evidence and anticipated increases in life expectancy within the next several decades, there are clear public health implications for the aging Canadian population.