Understanding Atrial Fibrillation
AFib is the most common heart rhythm disorder. Learn what it means, why stroke prevention is crucial, and the treatment options available to you.
What is Atrial Fibrillation?
Atrial fibrillation (AFib or AF) is an irregular, often rapid heart rhythm that originates in the heart's upper chambers (atria). Instead of beating in a coordinated way, the atria quiver chaotically, which can cause the heart to beat irregularly and sometimes too fast.
In a normal heart rhythm, electrical signals travel in an organized pattern, causing the heart to beat regularly at 60-100 beats per minute. In AFib, these signals become disorganized, and the heart rate can range from 100 to 175 beats per minute or more.
AFib itself isn't usually life-threatening, but it significantly increases your risk of stroke and can lead to heart failure if not properly managed.
Types of Atrial Fibrillation
Paroxysmal AFib
Episodes come and go, usually lasting less than 7 days. The heart returns to normal rhythm on its own.
Persistent AFib
Episodes last longer than 7 days. Treatment (medication or cardioversion) is needed to restore normal rhythm.
Long-standing Persistent
Continuous AFib lasting more than 12 months. May still be treated with rhythm control strategies.
Permanent AFib
AFib that is present all the time. Focus shifts to rate control and stroke prevention.
Symptoms of AFib
Some people with AFib have no symptoms at all, while others experience significant discomfort. Common symptoms include:
Heart Palpitations
Feeling like your heart is racing, pounding, or fluttering
Fatigue
Unusual tiredness or lack of energy, even with rest
Shortness of Breath
Difficulty breathing, especially during activity
Dizziness
Feeling lightheaded or like you might faint
Chest Discomfort
Pain, pressure, or tightness in the chest
Weakness
General feeling of weakness or reduced exercise capacity
AFib and Stroke Risk
Why Stroke Prevention is Critical
People with AFib are 5 times more likely to have a stroke than those without AFib. AFib-related strokes also tend to be more severe and disabling.
How AFib causes strokes: When the atria quiver instead of beating effectively, blood can pool and form clots. Over 90% of these clots form in a small pouch called the left atrial appendage (LAA). If a clot breaks loose, it can travel to the brain and cause a stroke.
CHA₂DS₂-VASc Score: Your doctor will calculate your stroke risk using this scoring system, which considers factors like age, sex, history of stroke, heart failure, high blood pressure, diabetes, and vascular disease.
Treatment Options
1. Rate Control
Medications to slow down your heart rate during AFib episodes:
- • Beta-blockers
- • Calcium channel blockers
- • Digoxin
2. Rhythm Control
Strategies to restore and maintain normal heart rhythm:
- • Antiarrhythmic medications
- • Cardioversion (electrical reset of the heart)
- • Catheter ablation (destroying tissue causing abnormal signals)
3. Stroke Prevention with Blood Thinners
Anticoagulant medications to prevent blood clots:
- • DOACs (Direct Oral Anticoagulants): Eliquis, Xarelto, Pradaxa, Savaysa
- • Warfarin (Coumadin): Older medication requiring regular blood monitoring
While effective at preventing strokes, blood thinners carry a risk of bleeding complications.
4. Watchman Device — An Alternative to Blood Thinners
For patients who can't tolerate long-term blood thinners, the Watchman device offers a permanent solution:
- Permanently seals off the left atrial appendage where clots form
- 96% of patients stop blood thinners within 1 year
- One-time, minimally invasive procedure
Living with Atrial Fibrillation
- Take medications exactly as prescribed — Missing doses can increase stroke risk
- Monitor your pulse regularly — Know your normal heart rate and report changes
- Limit alcohol and caffeine — These can trigger AFib episodes
- Manage stress — Stress and anxiety can worsen AFib
- Get adequate sleep — Poor sleep can trigger episodes
- Know the signs of stroke — Remember F.A.S.T.: Face drooping, Arm weakness, Speech difficulty, Time to call 911
Did You Know?
- 📊Over 12 million Americans will have AFib by 2030
- ⚡AFib is responsible for 15-20% of all strokes
- ✨Proper treatment can help most people live normal, active lives
Living with AFib?
Dr. Bleszynski can evaluate your stroke risk and discuss whether the Watchman device is right for you.
Schedule Consultation(702) 805-5678