Six Symptoms that Could Signal You Have Atrial Fibrillation

September is Atrial Fibrillation Awareness Month, a good time for a quick refresher on exactly what atrial fibrillation is and how it can affect one’s health.

In a recent Baptist HealthTalk podcast, electrophysiologist Bryan Wilner, M.D., with Baptist Health Miami Cardiac & Vascular Institute spoke about atrial fibrillation, or Afib, an electrical problem within the heart that causes an irregular heart rhythm.

Bryan Wilner, M.D., an electrophysiologist with Baptist Health Miami Cardiac & Vascular Institute

Dr. Wilner was joined by his patient Mark Watson, a Miami firefighter paramedic who earlier this year had an outpatient procedure performed by Dr. Wilner’s colleague, electrophysiologist Mario Pascual, M.D. That procedure – a catheter ablation – cured Mr. Watson’s AFib when medications and lifestyle changes couldn’t.

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

Atrial fibrillation is the most common type of abnormal heart rhythm, according to Dr. Wilner, who has special expertise in the medical management of complex arrhythmias. “The way that electricity normally conducts in the heart, you have a beat in the top chamber as it contracts, followed by a beat in the bottom chamber,” he explains. “With atrial fibrillation, the top chamber isn’t getting a nice contraction, so the beat is irregular. That in turn causes the bottom chamber’s beat to be irregular as well.”

When this happens, Dr. Wilner continues, blood isn’t being pumped out adequately and isn’t getting to where it needs to go, which can increase the risk of stroke. “That’s why if someone has any symptoms of atrial fibrillation, it’s so important that they be diagnosed and treated appropriately.” A quick and painless electrocardiogram (EKG) can easily confirm if someone has AFib, he adds.

What are the symptoms of atrial fibrillation?

Mr. Watson first noticed symptoms of AFib a couple of years ago, although he didn’t recognize it at the time. “If I was sitting down and I stood up quickly, I’d get a little bit lightheaded but it would pass and I would continue my day normally,” he recalls. “I also had some dizziness now and then but I didn’t realize it was actually AFib. I thought it was from working out and being overheated and dehydrated.”

It wasn’t until he had an episode that awoke him from a sound slumber that Mr. Watson knew something wasn’t right. “I know my resting heart rate. When I woke up in the middle of the night, my heart was racing and my heart rate was very high, in the low one hundreds,” he says. “Being a firefighter paramedic, I took my pulse and determined that it was atrial fibrillation.’

Mr. Watson knew he wasn’t going to die but he also knew he needed to see a doctor so the next morning he drove himself to South Miami Hospital where he had an EKG. By that time his heart rate had come down but he was still experiencing abnormal rhythm.

Dr. Wilner says that the symptoms Mr. Watson experienced – a rapid heartbeat as well as feeling lightheaded, faint or dizzy – are common with AFib. “The most common symptom is palpitations, which cause a fluttering or thumping sensation in your chest and make your heartbeat feel somehow ‘off.’”

There are also some more subtle, nonspecific symptoms, he says. Some people may feel like they’re more fatigued, short of breath or just have less energy, and some people with AFib have no symptoms at all. But “even asymptomatic patients could potentially be at increased risk of stroke, which is why surveillance is very important,” he points out.

Anyone experiencing these symptoms should see their physician as soon as possible, as they more than likely point to atrial fibrillation

How is atrial fibrillation treated?

AFib treatment focuses on getting the patient’s heart out of atrial fibrillation and into sinus rhythm, says Dr. Wilner, something that can be achieved either with medications or a simple procedure called catheter ablation.

The medications Mr. Watson had been taking were no longer effective, so he opted for the catheter ablation performed by Dr. Pascual. The minimally invasive outpatient procedure involves threading a tiny wire through the groin and up into the left atrium of the heart, where pulmonary veins there are then ablated, or destroyed, with a painless burst of energy.

“This essentially prevents the electricity that triggers the atrial fibrillation from leaving the pulmonary veins, keeping the heart in normal sinus rhythm,” says Dr. Wilner. “We have multiple long-term studies that show ablation is more effective than medicine in treating AFib. The outcomes are excellent, which is why it’s so common now. You come in the morning, you have the procedure done, you leave later that day and you’re back to living your life a day or two later.”

For Mr. Watson, the procedure was easy. “They wheeled me into the procedure room at 7:30 in the morning and I was back home later that day,” he says. “I was a little bit sore but no scars, just a little bruising and a little soreness for a day or two.”

Mark Watson, a Miami paramedic firefighter, suffered from atrial fibrillation until he had a catheter ablation by Mario Pascual M.D., at Baptist Health Miami Cardiac & Vascular Institute

Who is at risk for atrial fibrillation?

Dr. Wilner says there are several risk factors for atrial fibrillation, the most common being age. “There isn’t really a number one risk factor but anyone over the age of 65 has an increased risk of AFib,” he notes. “Other risk factors include hypertension, diabetes, prior heart attack, having heart failure, and prior stroke.”

Some of these risk factors can be controlled with lifestyle changes, Dr. Wilner points out. “People can control these risk factors by controlling their high blood pressure, controlling their diabetes, getting 30 minutes of aerobic exercise every day, and decreasing their alcohol consumption to less than one drink per day,” he says.