Hi all,
sorry if this is a stupid question, but I can't seem to find a clear answer anywhere else: re paroxysmal AF, what is happening with the heart between bouts of fibrillation? Is all well with the body or is there always some underlying unfelt fibrillation/heart condition occurring?
As far as I understand it once we are diagnosed with AF we are at a permanently higher risk of stroke regardless of whether or not we ever suffer another incidence of AF...?
Firstly yes AF makes us five times more at risk of stroke than somebody without AF. This is regardless of the number or strengths of events. That risk is further increased by various co-morbidities such as existing heart conditions, high blood pressure etc. leading to the CHADSVASC score which decides if you need anticoagulation or not. In fact is may be said that it is not so much AF which causes the stroke risk as the company it keeps.
To answer your main question you need to understand that AF occurs when the top left chamber of the heart (the left atrium) instead of beating in a regular manner, writhes like a bag of worms. This means that it is not passing blood down to the main pumping chamber (the left ventricle) and the normal electical triggers from top to bottom are confused resulting in an irregular heart beat. Whilst we inderstadn the mechanics of AF, what causes this is not really known although there are some conditions and substances which are known to promote it. (alcohol., ibuprofen over exercise to name three)
If your AF comes and goes it is known as paroxysmal and between events the heart will behave normally until the next trigger event. Unfortunately AF begets AF so the more you have the more you will get which is why it is most usually a progressive condition. Hope that helps.
Thanks for the prompt reply Bob. If the heart is behaving normally between fibrillation bouts I'm still not sure why we suffer occasional breathlessness, ectopic beats, palpitations etc when we are not "in AF" - or are these symptoms signs that the atrium IS actually fibrillating?
This would require careful diagnosis by a doctor. As I understand it, if the left atrium is slightly enlarged, this will encourage PAF *and* eventually breathlessness as the heart is less efficient.
Brilliant explanation BobD, thanks.
Unless you wear a monitor one can't pissibly tell what is happening. Ectopic beats are a normal function and everybody gets them . Palpitations just means you are aware of your heart and AF tends to make us such. Remeber many people are asymptomatic and quite unaware they have AF.
Although an Ectopic beat can exhibit as a sharp bump in the chest they are considered to be benign. It even might cause you to cough as response. Currently the CHADS scoring system does not differentiate permanent AF and PAF For treatment purposes one is deemed the same. However there is ongoing research regarding AF burden (time in AF). This research is questioning the logic of the CHADS approach and the treatment that flows from it. Ie it is taking the view that if not in AF then stroke risk factor should be lower and treatment appropriate to AF burden should be used. It is too early to say if the current approach to treatment will change, however my consultant considers that as my burden is around 1% I do not need anti coagulation but he reserves judgement if / when it creeps up. If you have the use of a Kardia monitor and can get an ECG reading there is a little bump before the sharp up and down line. When in SR it is present when in AF it is not and therefore there is a tendency for blood to pool in the left atria and clot. It would appear from the ongoing research that clot formation is a risk whilst in AF but not necessarily when in SR if there are no other co-morbidities present that heavily impact on stroke risk . These other factors are and will be present whether in SR or not.
I forgot to say that the little bump is the p wave and reflects the normal beat in the atria when in SR but there isn’t one whilst in AF.
Try this to stop your afib:
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After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??
Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer
PS – there is a new study out backing up the above observations. You can see it at
cardiab.biomedcentral.com/a...
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