Dr tells me AF is caused by a 'flabby' heart' !

[Elbows]

A question asked of a doctor at our first meeting of my local AF Support Group was what causes AF and the doctor said it was because the heart gets flabby! I've never heard this before so it would be good to get an expert answer. My doctor prescribed me Aspirin before I insisted on a anti coagulant. So I think GPs have lots to learn about AF too and I think 'flabby' heart answers are not helpful.

[BobD Volunteer]

Oh dear what a stupid man. First of all flabby is not a medical term and has no basis in any kind of science. AF is caused by rogue electrical impulses within the heart which make the atria fibrillate uncontrollably. It is possible for this to be caused by the atria becoming enlarged for example in endurance athletes but still nothing to do with flabby. The cause can be genetic if you have a particular shaped heart or damage (as above ) or due to surgery which can short circuit various areas.

You are quite right that very few GPs actually know much if anything about AF and few are up to speed on the latest guidelines. Sadly they often feel threatened when you correct or pull them up and can be quite difficult to manage even for strong willed individuals.

Bob

[Elbows in reply to BobD]

I at to bite my tongue Bob, it was the first AF Support Group Meeting and this was the medical lead for the practice! I decided it wouldn't be politic to challenge at the time so have invited the Arythmia Nurse at Bart's as our guest speaker for our next meeting who is going to talk about the causes of AF. I just hope the GPs in attendance pay attention?

[Hidden in reply to Elbows]

Well done Elbows. You should apply for a job in the Diplomatic Corp.

Koll

[BobD Volunteer in reply to Elbows]

Sounds like a plan!

[Jason1971]

Wow that is a little worrying. When I have to give presentations at work in certain subject, subjects I may not know a great deal about I still carry out research, so at least I stand a fighting chance in the Q & A's afterwards. If the Doc doesn't know a great deal about AF surely you think he would have read a little first. I'd be lost without Google.

[Beancounter Volunteer]

Hi Elbows

Two things worry me, firstly that your Doctor said he KNEW the cause of AF, particularly as you then say he was talking at an AF support Group Meeting? I would not invite him back if I were you.

And then the use of the term "flabby"? I mean come on it's so demeaning, I bet the same person would talk about "blood thinners" or maybe even tell you that Beta Blockers (or perhaps these little pills) might make you "tinkle" more often?

I am not so accomodating as you I suspect, I would have been unable to restrain myself as well as you obviously did. Well done.

By the way as I understand it in my "non-medical" way, he may be referring to enlargement of the left atria, as I understand it this MAY be caused by increased internal pressure, one reason of which may be AF itself, or other heart challenges such as mitral valve or ventricular problems. There appears to be disagreement about whether or not AF causes left atrial enlargement, or left atrial enlargement is a cause of AF.

Be well

Ian

[Hidden in reply to Beancounter]

Maybe he intended to say "flaccid" as the pulmonary views become "flaccid" due to high blood pressure." flaccidus" being the Latin word for " flabby"

[Japaholic]

Well, I now know my flabby heart is to blame.

Tosh!

[paulh1]

The only flab I see is between the doctors ears. This is truly unfortunate that a medical professional in this day and time would actually say that.

[Annaelizabeth]

Ridiculous! It wouldn't be worthy of comment if it hadn't come from a medical man!

[AFCyclist]

Flabby may not be a good descripive term but it was used by my cardiologist when he diagnosed my AF about 7 years ago. He said I had an enlarged flabby heart. I was a long distance runner, and am now a cyclist, and we had a discussion as to whether endurance sport had enlarged my heart. Their general view was that it was not due to endurance sport but they could not explain why it had occured. Since then I have given up alcohol, do regular longish distance cycles, and AF episodes have not got any more frequent and possibly slightly less. About one a month due mainly to anxiety/stress. Had an echo check recently but forgot to ask if there had been any change in the size of my flabby heart. I am on losartan and warfarin. Aged 66.

[Ianc2 in reply to AFCyclist]

Just been reading your 5 year old post. How are you getting on now?

[AFCyclist in reply to Ianc2]

Fine. Cycling 120 miles a week, now on an electric bike. AF episodes reduced considerably due to better control of exercise regime. Only about one every 3 months. EP wants me to have a pacemaker to help my left bundle branch block but I am saying no, at the moment, as my QOL is good.

[Timmo50]

I am interested about where this AF support group is based and if there are any in the Manchester area?

[Elbows in reply to Timmo50]

The Support Group is in the Matlock area of Derbyshire and we next meet in March and the details will be posted nearer the date on this site. If your looking for something nearer to Manchester you might want to attend one of these Regional Patient Meetings as follows:

This year AF Assocation, alongside Arrhythmia Alliance and STARS, will be holding regional patient meetings. Our patient meetings will provide an opportunity for patients and carers to meet and liaise directly with medical professionals, to pose relevant questions and gain a greater insight into developing technologies and techniques regarding their condition. We intend to visit the following locations with these meetings:

•Aberdeen

•Cardiff

•Exeter

•London

•Manchester

To register your interest please email [e-mail]

[maryjc in reply to Elbows]

Please can I have details of the Exeter UK meeting MaryC

[Elbows in reply to maryjc]

You need To register your interest by emailing [e-mail]

[Jason1971]

Definition of a "Flabby Heart" The second article mentions the heart being flabby, opposed to a condition called Flabby Heart. Still quite interesting.

medical-dictionary.thefreed...

medicineonline.com/topics/D...

[JonathanPittsCrick]

Oh dear! I often feel embarrassed when I hear doctors talking to patients using medical jargon, especially words which mean something completely different in "normal life". What he or she meant to say is that dilated cardiomyopathy (DCM) is an important cause of AF (which is true). In this condition the heart muscle, especially the left ventricle) becomes weak and less able to contract and so the pumping action is limited. Under exercise conditions, or even just lying down, more blood returns to the heart but can't get into the left ventricle from the left atrium (because the LV has not pumped much blood out) and so the pressure builds up in the left atrium which gets stretched. Enlargement and scarring of the left atrium due to repeated stretching is one of the main causes of AF. Over time the left ventricle also enlarges and the wall gets thinner, and it is this appearance of a dilated, poorly-contracting LV (as seen on an echocardiogram) that is described as "flabby".

A similar misunderstanding is horribly common when doctors talk of "heart failure" – for most people that is something very serious that you would expect to see on a death certificate! But medically it means a very specific thing: failure to exactly follow "Starling's law of the heart" relating input pressure with output flow volume. This can be so minor that it is hardly noticeable but causes terrible worry to patients who see it written in a report. And some doctors are so used to using this phrase that they don't realise that it is very scary for patients unless properly explained.