Q&A About Atrial Fibrillation with Our Electrophysiologists

CHI St. Vincent Heart Institute’s cardiac electrophysiologists, Drs. Mangaraju Chakka, Prabhat Hebbar and Thomas W. Wallace, answered questions about atrial fibrillation (AFib) and how it is managed.

What are the warning signs of AFib?

Dr. Chakka: The warning signs of AFib are variable. Some people don’t have many symptoms and don’t know they even have it, while some are very debilitated. The usual symptoms include palpitations, irregular or racing heartbeat, shortness of breath, fatigue or weakness and sometimes a discomfort or funny feeling in the chest.

How do I know if I’m at risk for AFib?

Dr. Wallace: The greatest risk factor is age. The older you get, the more likely you are to have AFib. That’s just a function of an aging heart. In addition, having a history of hypertension, diabetes or coronary artery disease is a risk factor. And then there are the good, old-fashioned reversible risk factors: obesity, sleep apnea, thyroid problems and drug and alcohol abuse.

Is AFib life threatening?

Dr. Chakka: In the big picture, it is not very life threatening, unless it’s a rare situation. It does have some impact on longevity, but the major problems are really quality-of-life issues, as well as developing other heart-related problems, such as weakening of the heart or stroke.

What treatments are available for AFib? If I have AFib does that mean I’ll need surgery?

Dr. Hebbar: AFib is one of those conditions where the treatment should be tailored to the patient and their individual health profile. If someone doesn’t have symptoms, we don’t need to address it with a procedure; lifestyle changes or medications will work. However for someone with a lot of symptoms we will want to be more aggressive.

Dr. Chakka: In terms of the treatment itself, it is very individualized to the patient and their health conditions. This can include procedures like shock or cardioversion to return to a normal heart rhythm, or a procedure called catheter ablation, which is minimally invasive, takes a couple hours and patients can go home the next day. Recently we’ve been performing the WATCHMAN® procedure, which allows AFib patients to stop taking blood-thinning medications.

Can healthy lifestyle choices control AFib?

Dr. Wallace: Good cardiovascular health at any stage of life is something that will lower your overall burden of AFib. Being 30 years old and exercising, keeping an eye on your blood pressure and not letting yourself get overweight is going to lower your chance of getting AFib when you’re 60. And for 60-year-olds, the same advice applies. Healthy living helps to keep blood pressure down and diabetes away, which in turn lowers your risk of developing AFib.

I know AFib increases your heart rate. Can I exercise if I have AFib?

Dr. Hebbar: It depends on whether you’re being treated for AFib or not. If you are new to the diagnosis and not on medicine to control it, your heart rate will go up naturally and at some point it may trigger your heart to switch into AFib. But patients who have AFib can and should exercise, we just want them to be on medicine or otherwise have it managed to keep their hearts from racing out of control.

Will my AFib ever be cured?

Dr. Wallace: AFib can be easily managed. If you have a true reversible condition—such as a tumor that is causing you to go into AFib—then in all likelihood you can be “cured” when the tumor is removed. However, for most patients we spend a lot of time with them talking about how we’re managing a chronic disease. In that respect, our most important role is managing their symptoms and making sure their stroke risk is appropriately assessed and addressed.