(Source: Heart Rhythm Society https://www.hrsonline.org/Patient-Resources)
The heart is a fist-sized muscle that pumps blood through the body 24 hours a day, 365 days a year, without rest. The normal heart is made up of four parts: two atria on the top of the heart (right atrium and left atrium), and two ventricles (right ventricle and left ventricle) which are the muscular chambers on the bottom of the heart that provide the major power to pump blood. These four chambers are connected by valves that allow blood to move forward and prevent it from flowing backwards. Coronary arteries, or blood vessels, deliver a constant, nourishing supply of blood to the heart muscle itself.
The heart’s pumping action, or “heartbeat,” is directed by a complicated electrical system. Problems with the regular heartbeat, such as abnormally fast or slow rhythms, can be caused by a heart attack (myocardial infarction) or aging, but may happen for other reasons as well. Heart rhythm problems can cause the feeling that the heart is “racing,” or “skipping” (palpitations), weakness, shortness of breath, passing out (syncope), and sometimes death.
Blockages in the coronary arteries can also cause major problems in the heart because they slow or stop the flow of blood to the heart muscle. If the heart does not get enough blood, pain (often called angina) or muscle death from a heart attack (myocardial infarction) can result which can damage the heart’s ability to pump and cause abnormal heart rhythms.
Although people can do a great deal to protect their hearts by exercising regularly, eating a healthy diet, maintaining a healthy weight, not smoking, and controlling their cholesterol and blood pressure, some people are born with a tendency to have heart disease or have other illnesses that may affect the heart.
Arrhythmias and Heart Disease
People with heart disease are at the highest risk for having arrhythmias (abnormal heart rhythms). So, reducing heart disease is important to lowering the risk of arrhythmias. Since the cause of an arrhythmia is not always clear, the best course of action is to prevent and treat heart problems, such as atherosclerosis (“clogged” arteries) and high blood pressure.
- Prevent heart disease by lowering risk factors that can lead to heart disease or cardiac heart rhythm problems, and by monitoring and treating any existing heart problems that you have.
- Make healthy lifestyle choices. Living a “heart healthy” life is the best way to reduce the chances of developing heart disorders. Exercising regularly, maintaining a healthy weight, and eating a healthy, low-fat diet with plenty of vegetables, fruits, and other vitamin-rich foods are the cornerstones of “heart healthy” living.
- Stop smoking and avoid secondhand smoke (smoke from other people). Tobacco contributes to as much as one-third of all heart disease.
- Avoid or limit the intake of caffeine, alcohol, and other recreational drugs.
- Avoid unnecessary stress, such as anger, anxiety, or fear, and find ways to manage or control stressful situations that cannot be avoided.
- Have regular physical exams and tell your doctor right away about any unusual symptoms you may have.
- Talk to a doctor about treating health problems that may contribute to abnormal heart rhythms and heart disease, including atherosclerosis (“clogged” arteries), heart valve damage, high blood pressure, high cholesterol, diabetes, and thyroid disease.
The following conditions can increase the chance of developing arrhythmias, or abnormal heart rhythms:
- Coronary artery disease (blockage in the arteries/pipes of the heart)
- High Blood Pressure
- High cholesterol
- A high-fat diet
- Excessive use of alcohol (more than 2 drinks per day)
- Drug abuse
- Family history of heart disease
- Advancing age (getting older)
- Sleep apnea
- Certain over-the-counter and prescription medications, dietary supplements, and herbal remedies
Monitoring and Treating Arrhythmias and Heart Disease
- Effectively treating any existing heart disorder is the best way to prevent it from becoming worse.
- Have regular checkups.
- Understand how some health conditions may increase the risk of abnormal heart rhythms.
- Learn about heart disorders, tests, and treatment options, and talk to your doctor or other health care provider.
- Find out if your heart’s electrical system and its ability to pump blood have been affected by heart muscle damage from a heart attack or another cause.
- Learn the importance of the ejection fraction (EF), which measures the pumping function of the heart. EF is a measure of the proportion, or fraction, of blood the heart pumps out with each beat. (Normal is about 50-70%.) An abnormally low EF is the single most important factor in predicting the risk of sudden cardiac death (dying from an abnormal heart rhythm).
- Follow treatment plans, and take all medications as prescribed.
- Report any new symptoms or changes in existing symptoms to your doctor/health care provider as soon as possible.
Treatment Adherence with Atrial Fibrillation
For patients with Afib, following your treatment plan will reduce your risk of afib-related stroke. Your cardiologist can estimate your risk of a strike using your age, sex, and other medical conditions such as high blood pressure, heart failure, diabetes and vascular diseases. A stroke or mini stroke in the past also increases the risk of having another stroke. Based on your personal risk, your cardiologist may recommend taking a blood-thinning medication to reduce the risk of having a stroke from Afib. Click here for more information on how adhering to your treatment plan is extremely important to reduce your risk of a stroke.
Stroke Prevention is the Cornerstone of Afib treatment
More than three million Americans have Atrial Fibrillation (Afib) which is the most common heart rhythm disorder. People with Afib have a stroke risk five times higher than those who don’t have Afib. Afib causes approximately 120,000 strokes each year. A stroke related to Afib happens when a clot breaks free, lodges in a blood vessel then blocks the flow of blood and oxygen to the brain. One out of every four strokes is due to afib. Click here for more information on Afib and stroke prevention and the role of anticoagulants.
Sleep Apnea and Atrial Fibrillation
About half of patients with Afib also have sleep apnea. Sleep apnea affects about 18 million people in the United States and 100 million worldwide. Sleep apnea is when breathing stops or becomes critically shallow during sleep. Click here for more information on sleep apnea.
Normally, the heart is signaled to contract, or squeeze, by an electrical impulse that starts in the sinus node at the top of the right atrium. The impulse then travels through the heart’s “wires” to the muscles of the lower chambers of the heart (the right and left ventricles), telling them to contract and cause a heartbeat. This natural system helps the heart pump in an efficient rhythm. A problem with any part of this system, through – either the heart’s natural “pacemaker” or the wires carrying the impulses – can cause a slow heart rate. An artificial pacemaker may be needed to reset the heart to the right pace and make sure blood and oxygen are pumped to the brain and other parts of the body. Click here to read more about what a pacemaker is and how it works.