Copyright Baton Rouge Advocate
Atrial fibrillation, or A-fib, is the most common type of arrhythmia, affecting at least 2.7 million people in the United States. This number is expected to grow to more than 12 million by 2030, which makes understanding the risks extremely important as A-fib can be life-threatening. Dr. Michael Bernard called A-fib a "silent threat" because symptoms can go unnoticed for months or years. Bernard is the section head of cardiac electrophysiology at Ochsner Health. A-fib, the basics A-fib is when the atrium of the heart, or the upper chambers of the heart, start to beat erratically and rapidly. Instead of the heart pumping together, chambers of the heart pump out of sync. "It's all chaos," Bernard said. "The heart shakes." A-fib treats people differently. Some people are very symptomatic, but many, or most, people don't feel it. The common symptoms include shortness of breath, fatigue, dizziness and chest pain. Younger people may feel the symptoms more than older patients because the arrhythmia is faster. "I've noticed that with patients, the more rapid the arrhythmia or the more rapid the heartbeat, the more likely they are to feel it," Bernard said. "The more normal heart rate a patient has, there's a higher chance of going undetected." A-fib is progressive and tends to get worse every month, every year. The symptoms, most likely, will get worse or become more prevalent the longer a patient has A-fib. Atrial fibrillation may be: Reducing A-fib through lifestyle Having a healthy lifestyle, limiting alcohol intake, controlling weight and exercising regularly help to reduce cardiovascular problems as a whole. Be on the lookout for dehydration, poor sleep or excess stress — all things that can lead to A-fib. "If you have obstructive sleep apnea, that puts pressure on the heart that can lead to atrial fibrillation," Bernard said. "If you want to prevent atrial fibrillation, do all the cardiac healthy things that can reduce your chance to developing it." To manage the heart rate, and suspected symptoms, Bernard recommends regular visits to family medicine doctors. "Screening starts at primary care offices," Bernard said, "with routine physicals once a year where they check your heart rate." The new frontier for diagnosis, treatment The next wave of atrial fibrillation includes treatment that uses artificial intelligence to help map the heart and find the source of A-fib — Bernard said Ochsner is an early adapter of this technology to help treat patients. Volta software is a type of the treatment meant for patients who have had prior ablations that have not held up over time. A-fib is most often detected by an EKG, but smartwatches and rings with monitoring technology have made the condition easier to detect in some cases. Smartwatches and rings, according to Bernard, have the advantage of getting a patient's heart rate for an extended period of time, allowing the device to get a comprehensive look at how the heart behaves in motion or at rest. "There's some commercially available gadgets that can find and detect arrhythmia," Bernard said. "We also have heart monitors that people wear now, or if you have a pacemaker or other type of medical device, those can detect (A-fib) too." According to Bernard, these devices are good, not great. The watches and the rings are a little farther from the heart than a pacemaker or heart monitor, so the reliability of the data isn't always great. But Bernard said he can't argue with results. "If people have a symptom event, we can't go back in time — it goes undetected," Bernard said. "What we're seeing now with smartwatches, wearable devices and some other things, is that we're tracking more people who didn't know they had a problem. We're catching these things a little more upstream with new technology — a new phase of information where we're able to see A-fib earlier than we used to."
