Does persistent/constant afib lower the heart ejection fraction?

[Efka]

Newbie question - it hadn’t even occurred to me but if one (aka my husband) has persistent/constant afib (and he has constant atrial flutter also we think) will that most likely impact the heart ejection fraction?

I mean now I think about it it seems logical that if the heart isn’t contracting and pumping in an orderly fashion that the ejection fraction will be impacted and thus lowered…

Is my thinking correct? Do many here have lowered EF? Or is it mainly a problem if one has both constant afib and heart failure?

Thanks for your help!

Eva

[CDreamer]

It’s a ‘could’ not a will. Being in persistent AF may raise the risk in some people but it’s a bit of a chicken and egg scenario in many medics minds - could HF cause the AF?

HF has many causes and you can have HF with a preserved EF so it is only ever one measurement. My husband had EF which dipped to 34 but as soon as AF was controlled it improved back up to 53.

Maybe ask your doctor for your particular circumstances and ask what the EF is?

[Efka in reply to CDreamer]

Thank you so much for sharing. And I will, bit of a strange complex situation going on right now so we have plenty of varying appointments upcoming hopefully by the end I will know and understand more, fingers crossed!

[BenHall1]

Hi Eva,

My EF in Nov 2020 was 68% ( aged 76) in Nov 2022 it was 60% ............. just natural aging as my AF was well controlled hardly existed .... in those days.

Something is troubling my heart at the moment ( still undergoing checks and tests ) and I've no idea what my current EF is but I'll get back to you later when I've seen my cardiologist. They have already identified a thickening of the walls of the left ventricle.

[Efka in reply to BenHall1]

I’m sorry to hear you have something going at the moment and I hope they can find “the culprit” and appropriate help. And thank you for sharing your (amazing!) EF figures, fingers crossed it is still good!

[Mugsy15]

My understanding (and personal experience) is that AF does lower the ejection fraction, yes. As you say, the efficiency of the pumping action is reduced and that is what is being measured. The EF figure is a bit misleading though - I recall being told mine was 42% or thereabouts and being horrified - I thought: "my heart is only working at 42% of what it used to???"

But no, that's not what the figure means. After cardioversion restored sinus rhythm mine rose to in the 50s and that, I was told, is excellent.

[Efka in reply to Mugsy15]

Thank you yes it does make sense. Really glad to hear cardioversion brought you back into SR and that that helped restore your EF.

[mjames1]

Yes, your thinking is correct . It can over time. That's why it's important to have your various tachycardias under control, as well as to have your heart functions monitored. Some newer studies, favor rhythm control in this regard (ablation and/or anti-arrhymic meds) but at a minimum you want your heart rate controlled. Hopefully this will all be discussed with you at your upcoming appointments. Good luck!

Jim

[Efka in reply to mjames1]

Thank you James! Yes fingers crossed for a good discussion around rhythm control one way or another… appreciate you for responding.