Dispelling Five Common Myths About Atrial Fibrillation
The more you know about this increasingly common condition, the better prepared you’ll be to treat it.
It’s estimated that nearly 3 million Americans have atrial fibrillation (AFib), with the rate of people developing this abnormal heart rhythm climbing rapidly. But despite the prevalence of this condition, there are numerous misconceptions about living with and treating AFib.
Afib is characterized by episodes in which the heart’s upper chambers, the atria, quiver or beat in an uncontrolled manner. The result is reduced blood flow to the rest of the body, and a higher risk of a blood clot forming in the heart and traveling to the brain, causing a stroke.
We let cardiologist Walid Saliba, MD, Medical Director of the Center for Atrial Fibrillation at Cleveland Clinic, address five of the biggest myths about atrial fibrillation and its treatment:
Myth: Occasional episodes of AFib mean that they won’t become more frequent or last longer later on.
Truth: “Typically, atrial fibrillation tends to come back, unless there was a clear and reversible reason why it happened the first time,” Dr. Saliba says. “Usually the episodes tend to become more frequent and longer with time. This progression is variable among patients.”
Afib is present in one of two forms: chronic and paroxysmal. In patients with chronic AFib, the heart’s rhythm is essentially abnormal all the time. These individuals may not be aware of their symptoms, or they may experience what seem like palpitations or a fluttering in the chest. Paroxysmal AFib is a condition in which episodes occur occasionally, but as Dr. Saliba notes, the frequency and intensity of such episodes can vary greatly from person to person.
Myth: Medication should always prevent future episodes of AFib.
Truth: Once an individual has been diagnosed with AFib, the first course of action is usually treatment with antiarrhythmic medications. These drugs are designed to either slow down a fast or uncontrolled heart rhythm, or help make the heart muscle tissue a little more stable in order to better tolerate AFib episodes.
“One of the goals of treating AFib is to reduce the burden of the episodes, in terms of reducing the frequency and the symptoms,” Dr. Saliba says. “Antiarrhythmic drugs work by helping to achieve that goal, but they are not a cure for AFib. It is expected that you will have AFib, even if you are taking these medications, but the hope is to have less AFib while on these medications to a point that is acceptable.”
Myth: Cardioversion is a permanent fix for AFib.
Truth: Electrical cardioversion, a procedure in which electrical current is used to try to reset the heart’s rhythm, is usually employed after it appears antiarrhythmic medications aren’t controlling the AFib. During the treatment, electrical pads or patches are placed on a patient’s chest.
While it can often be effective at halting an AFib episode, it’s not a treatment that has long-term effectiveness.
“Cardioversion is just a reboot,” Dr. Saliba says. “It restores normal rhythm, but does very little in terms of maintaining normal rhythm.”
Myth: You should have catheter ablation even if your medications seem to be working.
Truth: Catheter ablation is a procedure in which a catheter fitted with a special tip is guided to the location in the heart that appears to be the source of the arrhythmia. Then radio waves are administered through the catheter’s tip to burn, or ablate, a tiny piece of heart tissue suspected of causing the electrical problems.
“Catheter ablation is considered if the medications stop working to the patient’s satisfaction or if the patient cannot take the medications because of significant side effects,” Dr. Saliba says. Ablation is usually done in more serious cases of AFib, and has been shown to be more effective in patients with paroxysmal AFib than chronic Afib. Ablation carries some risks, so be sure to discuss those with your doctor.
Myth: Catheter ablation is a one-time only treatment.
Truth: “If an ablation does not work the first time around, a repeat (or touch-up) procedure may be done to improve the success rate and outcome,” Dr. Saliba says.
Research shows that repeat ablation procedures have a higher chance of being successful.