Understanding AFib, a serious but manageable health condition

A Q&A with Eric Van De Graaff, MD, a cardiologist with Methodist Physicians Clinic 

It’s estimated that over 12 million people in the U.S. have atrial fibrillation, or AFib, a condition that can lead to significant health problems. Just how common is AFib? Odds are pretty good that either you, a relative or someone you know has it. Just ask around.

Here’s what you should know about this serious condition, treatment options and why addressing it is so important.

What is AFib, and what are its symptoms?

AFib is an abnormal rhythm of the heart. But to understand AFib, you need to understand normal heart function. The heart is a muscle that contracts when an electrical stimulus is applied. We all have a “timer” in our heart that sends an electrical nudge once every second to tell the heart to contract. The effect of this coordination is a rhythmic, regular heartbeat that can serve you well for 100 years.

In AFib, you develop an electrical storm in your heart’s top chambers (the atria) that causes random, ineffective quivering of the atria (fibrillation). This leads to a chaotic racing of the main pumping chamber of the heart. The result is rapid palpitations that can lead to trouble breathing, chest pain, fluid accumulation and lightheadedness – all reasons to see a medical provider.

Meanwhile, people with AFib have an elevated risk for stroke – another important reason to seek care.

How can AFib cause a stroke? How do you address that risk?

Stroke is a serious potential byproduct of AFib. The fibrillation in the atria lends itself to the formation of small clots that can break free and travel to the brain, leading to a stroke. To combat this, Methodist cardiologists generally use medications that limit the clotting function of the blood. Of note: The term “blood thinner” is a misnomer, as powerful drugs like Eliquis, Xarelto and warfarin/Coumadin do help prevent clotting but don’t actually make the blood thinner. 

An alternative to such medications is a left atrial appendage (LAA) closure device. This device is a small plug that seals off a corner of an atrium where clots form. The device is inserted during a quick procedure that accesses the atrium through a vein in the leg.

What other treatments are associated with AFib?

There are several treatment options available to treat AFib. The simplest are medications that keep the heart from racing too fast – such as metoprolol (a beta blocker) and diltiazem (a calcium channel blocker). The next layer of treatment are medications that work to regulate a normal rhythm. These are drugs you may not be as familiar with: amiodarone, sotalol and flecainide.  

We sometimes recommend an electrical cardioversion, where we sedate a patient and then shock the heart back into normal rhythm. Although it sounds dramatic, it’s actually pretty low risk and simple.

We can also perform an ablation, where we create scar lines inside an atrium that block the spread of the electrical storm to the tissue of the top chambers. This procedure is performed by running a catheter from the groin to the heart, then freezing or burning tissue to create scars. This dramatically cuts the risk of slipping from normal rhythm into AFib, and recent advances in ablation technology have made this procedure safer and simpler than ever.

The bottom line

Yes, AFib is common and serious. But it’s also extremely manageable with the many safe and effective treatment options available. As with so many other health conditions, reaching out to your medical team is the first step to managing it and improving your quality of life.

Dr. Eric Van De Graaff, a cardiologist at Methodist Physicians Clinic, is especially skilled in the implantation of pacemakers and defibrillators. To schedule an appointment with Dr. Van De Graaff or another Methodist provider, visit bestcare.org/providers.