It is time to change how you think about atrial fibrillation (AFib) and AFib treatment.
In the latest AFib guideline from the American Heart Association and the American College of Cardiology, experts provide a long list of important updates for how doctors and patients can take on this growing health problem.
Some of the important takeaways from the guideline include:
- Thinking of AFib as a progressive disease, requiring different strategies at different stages.
- A greater emphasis on modifiable lifestyle and risk factors, like exercise, diet, and alcohol consumption
- New recommendations for treatment options — when patients should be prescribed antiarrhythmic drugs versus undergoing catheter ablation.
“This new guideline tries to emphasize the fact that atrial fibrillation is a complex disease, with risk factors that require addressing. So, the patient needs to be treated in a more holistic way, and then start talking about things like prevention and screening, for example,” Dr. José Joglar, a Professor of Internal Medicine at UT Southwestern Medical Center in Dallas and Chair of the writing committee of the AFib guideline, told Healthline.
What is AFib?
Atrial fibrillation (AFib) is the most common heart rhythm disorder. The condition is characterized by heart palpitations (rapid heartbeat) or irregular heartbeat.
Other symptoms include lightheadedness, fatigue, chest pain (angina), and shortness of breath. According to the CDC, 12.1 million people will have AFib in 2030.
AFib is caused when the heart’s upper chambers (atria) beat irregularly, which can disrupt blood flow to the lower chambers of the heart. Individuals with AFib are at higher risk of stroke, heart attack and heart failure.
The prevalence of AFib tends to increase with age, and because women tend to live longer, the condition is more common in women than men.
Know your AFib risk factors
According to the guideline, you should be thinking about AFib, even if you don’t have it, in terms of lifestyle and risk. Things like diet, exercise, smoking, and alcohol consumption are all known risk factors for heart attack and stroke, and AFib is no different. Those are all areas that you and your healthcare provider should be thinking about whether you’ve been diagnosed or not.
“This emphasis on lifestyle modification is really good to see,” Dr. Rod S. Passman, a Professor of Medicine and Director of the Center for Arrhythmia Research at Northwestern University, told Healthline.
Passman wasn’t involved in authoring the new guideline.
“For many people, changes in those aspects of lifestyle may have an impact. And then once you have the disease, we also recognize that more significant weight loss, more physical activity, minimization or abstinence from alcohol, smoking cessation, all those things can help us better control this disease,” he said.
If you don’t have AFib and want to help prevent it, managing your lifestyle and risk factors is important. But, even if you already have AFib, managing those risks will now play a greater role in your treatment across the lifecycle of the condition.
“There’s this increasing emphasis on pre-atrial fibrillation. So not just dealing with this disease once you have it, but trying to prevent it from occurring in the first place,” said Passman.
Lifestyle factors to prevent AFib
There are key factors that can help decrease your risk of AFib according to the guidelines. They include the following:
- Management of obesity
- Weight loss for people who are overweight or obese
- Regular physical activity
- Avoiding smoking
- Avoiding drinking in excess
- Maintaining a healthy blood pressure
AFib treatment options
Both Jogler and Passman also emphasize that the guidelines are changing how and when people may seek certain treatment options.
Catheter ablation, a procedure in which doctors use a long flexible tube (catheter) to destroy abnormal tissue and block irregular electrical signals within the heart to mitigate arrhythmia, has been given the OK as first-line therapy for some AFib patients.
“The data’s very clear that ablation is superior to any anti-arrhythmic drug that we have. It’s evolved over time that ablation is now considered a reasonable first-line treatment for rhythm control and atrial fibrillation,” said Passman.
In the past, patients would be prescribed antiarrhythmic drugs for managing AFib, before receiving catheter ablation.
“You don’t have to try medications first. You can go straight to catheter ablation because it seems to be superior in terms of effectiveness,” said Jogler.
Holistic treatment is the new standard
Most importantly, the guideline indicates that no matter where you are in the continuum of the condition, treatment and lifestyle must go hand-in-hand to help prevent and treat AFib.
“There has to be an ongoing holistic approach to patient management. You can do ablation, but also you need to address things like weight loss, alcohol moderation, and exercise. So this guideline emphasizes a multidisciplinary approach to therapy,” said Jogler.
For younger individuals, lifestyle changes and regular screening should be at the top of their prevention checklist. If you have AFib, depending on your lifestyle and risk factors, different treatment options are available including antiarrhythmic drugs and catheter ablation.
One thing is clear, though, the earlier you start — for both prevention and treatment — the better the outcome.
The bottom line
In a new guideline on Atrial Fibrillation (AFib) from the American Heart Association and American College of Cardiology, experts have updated how doctors and patients should think about and treat the condition.
Modifiable lifestyle and risk factors like diet, exercise, and smoking now play a larger role in the prevention and management of AFib.
Experts encourage everyone to think about AFib more holistically, in terms of prevention, management, and treatment.
