A racing heartbeat, fluttering sensation in the chest or unexplained breathlessness may seem like minor health concerns, but they could signal atrial fibrillation (AF) – the world’s most common sustained heart rhythm disorder and a leading cause of preventable strokes.
According to estimates from the Global Burden of Disease (GBD) study, nearly 8 million people in India are living with atrial fibrillation (AF). Experts warn that the condition is becoming increasingly common due to ageing populations and the growing burden of obesity, diabetes and uncontrolled high blood pressure.
Speaking to India Today Digital, Dr Christopher Granger, Fred Cobb, M.D. Distinguished Professor of Medicine at Duke University School of Medicine, said atrial fibrillation occurs when the heart’s upper chambers (atria) develop abnormal electrical activity, causing them to beat chaotically instead of in a coordinated rhythm.
“The electrical impulse travels in a chaotic way through the top of the heart, leading to an irregular and often rapid heartbeat,” Dr Granger explained.
WHAT ARE THE SYMPTOMS OF ATRIAL FIBRILLATION?
While some people experience obvious symptoms, many have silent atrial fibrillation, making the condition difficult to detect until serious complications develop.
Common symptoms include:
- Heart palpitations or a racing heartbeat
- Shortness of breath
- Fatigue or reduced exercise tolerance
- Irregular pulse
Dr Granger said people should not ignore persistent palpitations or an unexpected increase in resting heart rate. Smartwatches that detect irregular heart rhythms can also help identify people who may need further evaluation with an ECG.
WHY IS ATRIAL FIBRILLATION DANGEROUS?
The greatest danger of AF is its link to stroke.
When the atria fail to contract normally, blood can pool inside the heart, increasing the risk of clot formation. If a clot travels to the brain, it can block blood flow and cause an ischaemic stroke.
According to Dr. Granger, atrial fibrillation increases the risk of stroke by about fivefold, and one in every five strokes is associated with the condition. These strokes are often larger, more severe and more likely to leave patients with permanent disability.
AF can also contribute to heart failure by making the heart pump less efficiently, leading to fluid build-up in the lungs and worsening breathlessness.
WHY ANTICOAGULANTS ARE THE CORNERSTONE OF TREATMENT
The most effective way to prevent AF-related strokes is timely anticoagulation.
“Using an effective blood thinner can reduce about 70%of strokes caused by atrial fibrillation,” Dr Granger said, calling anticoagulants one of the biggest advances in preventing disabling strokes.
Treatment may also include medications to control the heart’s rhythm or heart rate. For some patients, catheter ablation – a minimally invasive procedure that interrupts abnormal electrical signals – can help restore a normal heart rhythm.
CAN ATRIAL FIBRILLATION BE PREVENTED?
Although age and genetics increase the risk, experts say many cases can be delayed or prevented by addressing modifiable risk factors.
Dr Granger recommends:
- Keeping blood pressure under control
- Managing diabetes and cholesterol
- Maintaining a healthy weight
- Exercising regularly
- Avoiding smoking
- Limiting alcohol intake
- Getting adequate sleep and seeking evaluation for sleep apnea if needed
He noted that moderate tea or coffee consumption does not appear to increase AF risk and may even be associated with a lower risk in some studies.
Beyond protecting health, preventing AF-related strokes also reduces the financial burden on patients and healthcare systems.
“The cost of anticoagulant therapy is far outweighed by the cost of treating disabling strokes and their long-term complications,”Dr Granger said, stressing that early diagnosis and timely treatment remain the most cost-effective strategy.
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