AFib Awareness: Irregular Heartbeats May Not Be Life-Threatening, But Here's What You Need to Know

While fluttering and heart palpitations can be signs of AFib (atrial fibrillation), the most common type of irregular heartbeat, there can be simple explanations. But getting tested is the wisest move because AFib, if untreated over a period of time, can result in serious conditions, including clots, stroke, heart failure and other heart-related complications.

September is National AFib Awareness Month. The American Heart Association reminds everyone that a racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present, such as shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. 

When an irregular heartbeat, or arrhythmia, lasts long enough to affect how well the heart works, more serious symptoms may develop. While feelings of having a fast-beating, fluttering or pounding heart can happen occasionally during stressful moments or during intense exercise, it’s best to consult with your primary care physician to make sure there are no underlying issues.

An electrocardiogram, also called an ECG or EKG, is the most common tool used to initially diagnose an arrhythmia. Your doctor may order additional cardiac imaging tests, such as an echocardiogram, magnetic resonance imaging (MRI), or CT scan.

Common Misconceptions About Arrhythmias

Mario Pascual, M.D., an electrophysiologist with Miami Cardiac & Vascular Institute.

Nonetheless, most irregular heartbeats are not life-threatening, explains Mario Pascual, M.D., an electrophysiologist with Miami Cardiac & Vascular Institute. “There a couple of common misconceptions about arrhythmias,” explains Dr. Pascual. “One is that every irregular heartbeat is potentially life-threatening and it’s not. There are certainly dangerous arrhythmias out there, but there are many benign arrhythmias as well.”

And, he adds, there’s also a belief that every heart rhythm issue has to be evaluated in the emergency room. “And most of them do not,” said Dr. Pascual. “We can come up with a treatment plan for a patient so that if they have some type of arrhythmia, even if they’re at home, we can provide a good treatment option to avoid the emergency room and hospitalizations.”

AFib occurs when the heart’s upper chambers beat irregularly and can increase stroke risk fivefold if left untreated. It will affect an estimated 12.1 million people in the U.S. by 2030, according to the American Heart Association.

Young People and Alcohol Consumption

Moderate to heavy drinking over an extended period may increase the risk of AFib in adults under 40, according to a new study from South Korea. Previous studies have linked higher alcohol consumption to increased risk of AFib, but there has been minimal research in younger adults, says Dr. Pascual.

“We know that alcohol is a direct toxin to the heart,” he explains. “We know that alcohol can certainly trigger atrial fibrillation. So, in our AFib patients, we always recommend decreasing their alcohol intake. This study did not show that caffeine was related to the development of AFib. We used to think that caffeine may play a role in AFib as well. That has not been consistently demonstrated. “

Younger patients that complain about an irregular heartbeat are counseled about alcohol use, as well as any family history of heart conditions that may be linked to AFib. 

“In patients that develop AFib at a very young age, we do suspect that there’s a genetic or familial history component to the AFib,” said Dr. Pascual. “We haven’t yet identified exactly what genes, but we are starting to see a relationship. This is something that is actively being studied.”

Is Arrhythmia Preventable?

Arrhythmias, including AFib, are definitely preventable, said Dr. Pascual. Most people at high risk can prevent AFib by focusing on modifying and reducing risk factors that involve making healthy lifestyle choices, which include focusing on weight management, regular exercise, getting medical screenings and avoiding excessive alcohol consumption and not smoking.

“I always tell patients they really have the opportunity to prevent arrhythmia from occurring in the future,” said Dr. Pascual. “If you’ve been diagnosed with atrial fibrillation, studies show that if you’re able to lose greater than 10 percent of your weight, if you’re able to treat your sleep apnea, and if you’re able to control hypertension or high blood pressure, more than 50 percent of these patients can remain AFib free as long as they do those things.”

If patients don’t take these steps, less than 10 percent of them be AFib-free over the short-term, he adds.

“So, risk-factor modification works,” emphasizes Dr. Pascual. “If you can maintain a good weight and stay physically active, and if you can decrease your alcohol intake and make sure that you don’t develop high blood pressure or diabetes — then you have a very good chance of not developing some type of heart arrhythmia in the future.”