Understanding. Atrial Fibrillation. For more information, visit. CardioSmart.org/AFib

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1 Understanding Atrial Fibrillation For more information, visit CardioSmart.org/AFib

2 Understanding Atrial Fibrillation What is ATRIAL FIBRILLATION (AFib)? When it s operating normally, your heart pumps to a strong, steady beat. The heart has an electrical system that tells the heart s muscle when to contract. But in people who have atrial fibrillation (AFib), the heart s electrical impulses don t work like they should. It can feel like your heart is racing, fluttering or skipping beats. AFib is the most common heart rhythm disorder (arrhythmia). It can cause blood clots in the heart that can travel to the rest of the body and cause strokes or block blood flow to other organs. Indeed, people with AFib are five times more likely to have a stroke than people who don t have it. AFib can also lead to heart failure. Because it can lead to lifethreatening conditions, it s important to detect and treat AFib as soon as possible.

3 CardioSmart.org/AFib Atrial Fibrillation (AFib) is a PROBLEM with the RATE OR RHYTHM of the heartbeat, causing the heart to beat quickly and irregularly. More than 3 million Americans have AFib. There are three basic types of AFib: PAROXYSMAL AFib comes and goes, often stopping on its own. PERSISTENT AFib lasts more than one week. It can become permanent. PERMANENT The heart s normal rhythm cannot be restored.

4 Understanding Atrial Fibrillation Risk factors for AFib A number of factors can put you at a higher risk for getting AFib. These include: Older age, although AFib can happen at any age Any condition that puts added strain on the heart, including: High blood pressure (hypertension) Previous heart attack Heart surgery Valve disease Heart failure Other conditions such as obesity, sleep apnea or hyperthyroidism (overactive thyroid) A family history of AFib Drinking too much alcohol (regularly drinking 3 or more drinks per day, or binge drinking)

5 CardioSmart.org/AFib The Signs of STROKE Stroke is what happens when a blood vessel leading to the brain bursts or is blocked. It s a leading cause of death in the U.S. The SIGNS OF STROKE are: Severe headache and confusion Vision changes Trouble speaking Numbness, tingling or weakness Loss of balance Loss of movement in the face or limbs, especially on one side If you think you re having a stroke, CALL 911 RIGHT AWAY.

6 Understanding Atrial Fibrillation What can trigger AFib AFib can be triggered by a number of behaviors or conditions: Drinking too much alcohol Consuming too many stimulants, such as caffeine Severe stress, from fighting infection or having surgery It s a good idea to make a note of what triggers your AFib so you can share that information with your health care team. Symptoms: How AFib feels Not everyone who has AFib gets symptoms. For those who do, AFib can feel like... FISH FISH IN MY CHEST DRUMS DRUMS IN MY CHEST THUNDER THUNDER IN MY CHEST AND IT INCREASES More than 2.5 million adults experience the same More than pounding, 2.5 million adults experience same flopping, or rumbling, but the many do flopping, pounding, or rumbling, but many do not know they could have atrial fibrillation ( A-Fib). not they could atrial pulse fibrillation A-Fib). A-Fibknow occurs when thehave electrical in the(heart s A-Fib occurs when the electrical pulse in the heart s upper chambers causes rapid and irregular heart upper causes and irregular beats. chambers As a result, life s rapid ever yday tasks canheart feel beats. As a result, life s ever taskscondition can feel exhausting. This serious but yday treatable exhausting. serious but treatable condition can increase This your risk of stroke, hospitalization, and can increase stroke, hospitalization, and appointment today to discuss heart disease.your Makerisk anof appointment today discuss heartsymptoms disease. Make your and an treatment options withtoa doctor. your symptoms and treatment options with a doctor. STROKE RISK BY 500% MyAfib.org

7 CardioSmart.org/AFib Other SYMPTOMS include: Unusual fatigue Fatigue or tiredness Unexplained Shortness shortness of breath Dizziness or fainting spells s Chest Chest pain (angina)

8 Understanding Atrial Fibrillation Diagnosing AFib Your doctor will determine whether you have AFib by doing a series of tests. He or she likely will begin with a complete medical history and physical exam. From there, tests will help identify your heart rhythm problem. These may include: Electrocardiogram (ECG): This test uses electrodes to record your heart s electrical activity and any deviations that are affecting it. Holter monitor: This portable ECG measures and records your heart s electrical activity for 24 hours. Event monitor: By pushing a button on this device, your heart s electrical activity is recorded via electrodes while you are having symptoms. People generally wear an event monitor for one month. Echocardiogram: This ultrasound test takes pictures of your heart and measures how well the chambers are pumping. Occasionally, people are diagnosed with AFib during a hospital emergency department visit.

9 CardioSmart.org/AFib Treating AFib The good news is that AFib can be treated successfully, and you can live a full life even with AFib. Several factors will affect your treatment options: Your age Your symptoms and how often you experience AFib Whether your heart rate is under control Your risk for stroke Other health conditions, including other heart disease Many patients receive more than one treatment option. Lifestyle changes are often part of it, as are medications or procedures to control heart rate or rhythm. Also, steps to prevent blood clots and stroke are often part of the treatment plan. Lifestyle changes Adopting a heart-healthy diet is nearly always part of the treatment plan. That means eating plenty of fruits and vegetables, fiber, lean meats and unsaturated fats. Limiting alcohol and caffeine is also a common approach.

10 Understanding Atrial Fibrillation Getting plenty of routine physical activity is another important treatment option. In general, most people should aim to get 30 minutes of moderate-intensity physical activity most days of the week. Keep in mind that you don t LIFESTYLE have to get your exercise in all at once. You can break it into three 10-minute sessions and still benefit. Also, consider adding more activity into your day: Park the car farther from your destination and walk the difference. Take the dog for a walk. Invite family and friends to join you. Get off the bus or subway a stop or two before your destination and walk. Take the stairs instead of the elevator or escalator. Also important is to avoid smoking, or quitting if you already smoke. Smoking is terrible for your health in general and can make AFib worse. If you smoke, talk with your health care professional about ways to help you quit. There are many good medications and programs to support you. Also, call the Quit Line at QUIT-NOW.

11 CardioSmart.org/AFib In addition, stress can make AFib worse, so keeping it at bay is important. There are many good ways to manage stress, including: Practicing deep-breathing exercises. Enjoying a favorite hobby Reading a good book Taking a relaxing bath Yoga or tai chi Meditation or prayer Medications Several types of medication are used to control AFib. Many people take more than one type to treat their condition. Whatever you re prescribed, it s important that you take your medication exactly as prescribed at the same time every day, with or without food (as directed), at the correct dose and the right number of times. Your medications can t work as they should unless they re taken the way they re supposed to be.

12 Understanding Atrial Fibrillation Stroke prevention Medication is used to prevent or treat blood clots and lower your risk for stroke. These medications include: NTICOAGULATION Aspirin Blood thinners (anticoagulants), such as warfarin and newer medications, including apixaban, dabigatran and rivaroxaban People who take blood thinners must be very careful about avoiding falls and other accidents that may cause bleeding. If you take blood thinners, you may have to watch how much you eat of certain foods. For example, people who take warfarin need to be careful around foods rich in vitamin K, such as spinach, kale and other vegetables. If you take warfarin, be careful to consume the same amount of such vegetables every day. People who take warfarin must also have their blood checked routinely. Rate control In addition to blood thinners, medications to control heart rate are sometimes prescribed. RATE

13 CardioSmart.org/AFib These can include: Beta-blockers: These medications block the effects of certain hormones on the heart, slowing the heart rate down. Calcium channel blockers: These slow the heart rate down by blocking the number of electrical impulses that pass from the heart s upper chambers (the atria) across the AV node to the lower chambers (the ventricles). Digoxin: In addition to slowing the heart rate down, digoxin strengthens the ventricles contractions so they can pump more blood. Rhythm control Another treatment approach is prescribing medications to control heart rhythm. These help restore the heart s normal rhythm RHYTHM and can help maintain it. They can also help reduce the heart rate when AFib symptoms occur. These medications include: Amiodarone Dofetalide Dronedarone Flecainide Propafenone Sotalol

14 Understanding Atrial Fibrillation Medical procedures Sometimes more than medication is needed to treat AFib. Electrical cardioversion: In this procedure, paddles producing a lowvoltage electrical shock are applied to the chest to help restore a normal heart rhythm. Catheter-based ablation: A long, thin tube (called a catheter) is inserted through a vein in the leg and threaded to the heart. An electrode at the tip of the tube emits radio waves that create heat, which destroys the heart tissue that is causing AFib. Surgical maze: During open-heart surgery, small scars are made on the heart, creating a maze that helps prevent abnormal heartbeats from controlling the heart. Pacemakers: During surgery, these devices are implanted near the heart to help control the heart s rhythm. Atrial defibrillators: These devices are also implanted during surgery and help shock the heart back to a normal rhythm during an AFib episode.

15 CardioSmart.org/AFib Talking with your care team Living with AFib can be a challenge. That s one reason why it s so important to talk with your health care team about any concerns you have. You might consider asking your doctor: What type of AFib do I have? Is it permanent? How are medications to control my heart rate different from those to control my heart rhythm? Which type is right for me? What is my risk for having a stroke? What can I do to reduce my risk? Which blood-thinning medication makes the most sense for me? What can I do to prevent AFib episodes? How much and what type of exercise should I be getting? Do I need a device or surgery? Will I need one in the future?

16 Resources For more information, visit CardioSmart.org/AFib Heart Rhythm Society: HRSonline.org National Heart, Lung, and Blood Institute: NHLBI.nih.gov National Stroke Association: Stroke.org Stop AFib: StopAfib.org American Heart Association: Heart.org CardioSmart partnered with the Heart Rhythm Society and Men s Health Network on this brochure. This program is sponsored in part by Bristol Myers Squibb Pfizer. For more information, visit CardioSmart.org/AFib Information provided for educational purposes only. Please consult your health care provider about your specific health needs. 2017, American College of Cardiology