AF Association
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AF won't kill you

I have read this many times in this forum. And find it reassuring.

Could someone explain whether the statement needs to be qualified.

My understanding is that persistent rapid AF may over a long period cause cardiomyopathy leading to heart failure. This is the basis for taking rate control meds.

And of course without anticoagulants we may have a major stroke.

Neither situation is inevitably fatal but can be.

Can we modify the aphorism to say AF probably won't kill you but might if you completely ignore it. As is, the statement might encourage complacency, both in patient and doctor.

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Badger I use the expression to re-assure newly diagnosed people that their life is not about to end.

Yes uncontrolled AF may lead to cardiomyopathy but we know that even if this arose through neglect it can reverse once treatment is given.

Heart failure is generally a long term problem and again not an instant killer. The term merely means that your heart is unable to fulfil all the demands your body makes on it.

AF makes us more prone to stroke obviously but what does than mean? Generally they say five times more likely but five times what? If you are young and fit with no co morbidities one might say five times zero.

So you see AF alone doesn't kill. It is the company it keeps as Dr Gupta has said several times.

Surely the point it that when people read this statement they have already been diagnosed and are under treatment so I would say it it still valid. I fear for all those undiagnosed souls who only discover they have AF when the stroke cripples them.

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Agree totally with what Bob has written here.

Jean

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I am inclined to agree with you here Badger. I was first diagnosed 25 years ago and have been on every drug and treatment . When I was left in fast AF on a list for cardioversion I developed pulmonary oedema and in spite of visiting GP who couldn't detect anything I eventually presented at A&E when I could barely walk . If I had not done so I don't believe I would have been alive today. The cardiac registrar told me that this was a direct result of my long AF history ( at that time 16 years )

Sandra

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I have found the phrase " AF won't kill you" very reassuring and calming during episodes. Patently untreated and persistent fibrillation isn't going to do a heart any good. Any organ that is subject to strain is likely to fail.

AF is a hateful condition but there are worse things out there.

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I think you are right about qualification and Bob is correct in pointing out that it is the company it keeps which could be a killer but having had AF for more than 10 years I no longer worry or even think about it as I know I have done everything I can to limit and manage the condition.

About 3-4 years ago we went away for Christmas and met a family whose 26 year old son had died as a direct result of AF. This shocked me at the time but learning more I discovered that he had ignored the symptoms of very fast, irregular heartbeat for quite a long time and continued to ‘push through’ whilst exercising and as a consequence overstrained his heart, collapsed and sadly died.

He is the only person I ever heard of who died as a direct result of AF although I know sudden cardiac death is associated with AF in young, fit people and rather suspect this may have been the case.

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Very well put Badger, I was told it wouldn't kill me and wasn't life threatening but I think only in terms of comparison to an MI or heart stopping which during the initial onset was reassuring to me and family.

However as has been said it's what comes with it if uncontrolled or uncoagulated depending on other health issues as well.

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I always understood that from my doctor to mean that it's not the AF it's the stroke or blood clot that will kill you from untreated AF.

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It is a bit like saying food doesn`t give you indigestion

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If you were to moderate it you'd have to be more specific- if someone has non- symptomatic AF with a normal heart rate they are not putting massive strain on their heart whereas if they ignored a fast heart beat in af and had no rate control then yes, they might get heart failure. The other problem is a chicken and egg one- yes mortality figures in AF may be worse than non AF but that's often because underlying heart problems and other illnesses will lead to AF- so the answer has to be individualised to be really prognostic. I think everyone on here is sensible enough to get treatment if they have lots of symptoms.I think clinicians mean AF won't kill you- IF you don't have other factors I've mentioned and you take your treatment.

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I always took "AF won't kill you" to mean simply that you won't die during an episode because your heart stops beating, which it won't. I never read anymore than that into it. Several weeks ago, someone in this forum recounted how she had an episode while she was driving. She passed out and rolled her car. She survived, but it wouldn't necessarily have turned out that way. So AF can kill you indirectly, but not directly.

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I missed that post Brad. Are you able to put a link to it.

Many thanks

Jean

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No I can't, sorry. It was probably at least 5 or 6 weeks ago, but I don't remember who or exactly when. I just remember reading it.

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It always seemed to me that AF increases other life risks, even if it won't kill you directly. I wouldn't go climbing mountains or doing Arctic exploration knowing I can get AF. I'm not even sure that adventurous small boat sailing alone is a good idea any more. I may even sell my boat.

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Instinctively I agree with you. Rationally, I'm not sure. Are we allowing our health to compromise our zest for life? Maybe we should have some of what Sir Ranulph is having!

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It's a phrase that I've never seen used in isolation. You can take any part of a total conversation and analyse it, and it will be wrong. The media make a living out if it 😀.

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I was diagnosed two years ago this month when I went to my GP in the middle of an episode. I went home and googled 'Atrial Fibrillation' and as a result of the horror stories and sites I visited, I wrote to my siblings telling them all about this serious condition I had been diagnosed with. I truly expected to die any day. I then found this site, and normality returned to my life. My mantra became 'AFib won't kill you, it's the company it keeps'. So I make sure I take my medication, I have become informed and much more knowledgeable, I feel (mostly) in control. Like the others, I have never taken the phrase in isolation.

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What about 'Treated AF wont kill you'?

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Love that slogan!

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I was told by a consultant at Royal Stoke Hospital that AF was more inconvenient than life threatening that was after my heart rate had been as high as 160 Bpm. But also told by another consultant that in his view everyone over 70 with AF should take anticoagulant as if your heart is beating to fast your blood does not get pumped out of your heart correctly so a possibility of blood clots which can lead to a stroke. So he reccomended taking small dose of Warfarin every day. I have been on around 3mg per day for the last two years without any problems just a blood test is required every month. I have also had a Catheter Ablation at Stoke a year ago which most of the time has controlled my heart rate to between 50 & 60 BPM. If I do get the odd day when it goes upto around 90bpm I Control it with one tablet of 25mg Atenolol as required. This works very well for me.

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presumably anti-coagulation doesn't make you immune from stroke. Are there any figures on how much it lessens the risk?

I'm also suspicious of how CHA2DS2-VASc doesn't take into consideration how often you get AF or how long it lasts for. It seems to be that someone with persistent AF would get the same score as someone who gets AF for 5 minutes every few months. That doesn't seem right to me.

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ncbi.nlm.nih.gov/pmc/articl...

64% risk reduction according to this review. Not sure if this applies to PAF

This seems a possible argument in favour of ablation in PAF if 36% are not protected

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Also, see the YouTube video by Dr Sanjay Gupta on this subject. He reckons the stroke risk is more to do with the frequent co-morbidities than with AF itself. If you are youngish and healthy, the evidence is that your risk of stroke is not raised by AF. But yes you do need to keep heart rate under control. Keep calm and carry on!

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I had an ablation which, in the main fixed the problem and I have not had a repeat of a 208 bpm or AF. I do think that whilst people should be reassured, it should be qualified by the statement that AF should be diagnosed by a healthcare professional and appropriate treatment commenced. Many people now diagnose themselves by referring to forums like this one and I think it is inappropriate to post the bald statement that AF will not kill you, I am sure that a doctor would not make that statement !

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