Doctor, I Was Told To Have Atrial Fibrillation
Patient: “Doctor, I went for a routine check of my high blood pressure yesterday and I was told to have Atrial Fibrillation! What is this?”
Doctor: “Oh, I see. Atrial Fibrillation (AFib) is the most common serious heart irregularity that we see in medical practice. It is a condition where the heart beats irregularly and often rapidly.”
Patient: “What exactly happens in Atrial Fibrillation?”
Doctor: “In AFib, the upper chambers of the heart, called the atria, just shiver chaotically and out of sync with the lower chambers. This can lead to blood clots forming in the atria, which can then travel to the brain and cause a stroke. It also makes the heart work inefficiently.”
Patient: “I feel fine, though. Should I still be worried?”
Doctor: “Many patients have disbelief and are reluctant to start treatment when AFib is diagnosed without symptoms. However, even if you feel fine, AFib can increase your risk of stroke and heart failure. Feeling well does not always mean being well, and AFib is like an alarm in silent mode.”
Patient: “How can you tell if someone has AFib?”
Doctor: “We usually detect AFib through an electrocardiogram (ECG), which records the electrical activity of your heart. Physical exam where we feel your pulse can give us a clue. I had a 68-year-old lady recently who came because she had palpitations and dizziness. Though she was feeling fine, her pulse was irregular and fast, which helped me diagnose AFib with the help of an ECG.”
Patient: “Is it possible for people to check for Atrial Fibrillation at home?”
Doctor: “A definite diagnosis of AFib requires an ECG. However, some symptoms like fast heart beats and missed beats should alert them, especially if these symptoms are accompanied by dizziness, fatigue, or breathing difficulty. In such situation, they should see a doctor. In addition, some smartwatches like the Apple Watch and Samsung Galaxy Watch can detect irregular heart rhythms, but these should not replace professional medical advice at this time.”
Patient: “What causes AFib?”
Doctor: “AFib can be caused by high blood pressure, heart disease, obesity, some thyroid diseases, excessive alcohol or caffeine consumption, and other factors. Sometimes, it occurs without any clear reason.”
Patient: “Can AFib be treated?”
Doctor: “Yes, there are several treatment options for AFib. These include medications to control your heart rate and rhythm, blood thinners to prevent clots and stroke, and procedures like cardioversion or ablation.”
Patient: “What about herbal or alternative treatments? I have read that they can cure AFib.”
Doctor: “While some alternative treatments may claim benefits, they should be approached with caution. Unlike conventional treatments, many herbal remedies lack rigorous scientific testing and evidence. Some may even interact negatively with prescribed medications.”
Patient: Are lifestyle changes helpful?
Doctor: Yes. Regular exercise, healthy diet, avoiding alcohol and caffeine, and stress management can help manage AFib. Regular medications are very important.
Patient: “Can you give an example of how diet affects Atrial Fibrillation?”
Doctor: “Certainly. Diet plays a significant role in managing AFib. For example, excessive alcohol intake can trigger AFib episodes. Similarly, high levels of caffeine can also lead to irregular heartbeats. On the other hand, a diet rich in fruits, vegetables and whole grains can help maintain a healthy heart. Consumption of more than 2 litres/ week of sweetened beverages increase the risk of AFib by 10-20%. However, pure fruit juice (without sugar) reduces the risk by 8%. In addition, reducing sodium intake can help control blood pressure, which is beneficial since high blood pressure is a common cause of AFib.”
Patient: “Does the treatment require regular check-up?”
Doctor: “Regular follow-ups and ECGs are required. In addition, scientific understanding of their own condition can help patients manage their AFib effectively. Knowledge is power!”
Patient: “What if I don’t want to start treatment right away?”
Doctor: “AFib is a stealthy condition. It is important to understand that AFib can silently increase your risk of serious complications like stroke. Even if you feel fine now, untreated AFib can lead to severe problems in the future. Starting treatment early can help prevent these complications.”
Patient: “Thank you, Doctor. I appreciate the information.”
Doctor: “You are welcome. If you have any more questions or concerns, feel free to ask.”
This article is part of the Honest Conversations series: Explore the articles from this series:
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- Doctor, I Was Told To Have Atrial Fibrillation
- Doctor, Can I Avoid Cancer?
- Doctor, I Have Vertigo. What Can I Do Now?
- Doctor, Tell Me About High Blood Pressure
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- Honest Conversations in Healthcare – A Series
Dr Shashikiran Umakanth (MBBS, MD, FRCP Edin.) is Professor & Head of Internal Medicine at Dr TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, India. He shares his insights on Medicine, Health and Life here.
