A racing heart, dizziness or new shortness of breath while walking uphill could signal atrial fibrillation, a common heart rhythm disorder that can increase the risk of stroke and heart failure, an Atrium Health specialist says.
“Early detection is absolutely key,” said Helen Rominiecki, a nurse practitioner at Atrium Health’s Sanger Heart & Vascular Institute.
Speaking during a media briefing as September’s AFib Awareness Month drew to a close, Rominiecki urged people to recognize changes in how they feel and seek medical evaluation promptly.
Atrial fibrillation, often called AFib, causes the heart to beat irregularly and frequently rapidly. It affects more than 10 million Americans, she said.
“We see long-term consequences of untreated atrial fibrillation,” Rominiecki said.
An irregular heartbeat can allow blood clots to form in the heart. Those clots can dislodge and cause a stroke, she said. A persistently rapid heart rate also can lead to heart failure.
Common symptoms include palpitations, a rapid heartbeat, dizziness and lightheadedness. Some people first notice a change during activities they previously handled comfortably.
“One of the most common symptoms that I hear people complain of is when they’re walking up an incline, they used to be able to do it with ease,” she said. “And now they’re noticing that they’re becoming short of breath with exertion.”
Some patients have no noticeable symptoms. Increasingly, Rominiecki said, people are learning of a possible rhythm problem through consumer monitoring devices such as an Apple Watch.
An electrocardiogram, commonly called an EKG, is used to confirm the diagnosis.
“The most important way that we diagnose this is by EKG,” she said.
Age and family history increase the risk of developing AFib. Other risk factors include high blood pressure, diabetes, obesity, untreated sleep apnea, coronary artery disease, smoking and heart failure, she said.
Managing those conditions is an important part of treatment and may help reduce the likelihood that AFib will return after medication or a procedure. Rominiecki also recommends weight loss when appropriate and a Mediterranean-style diet.
Treatment addresses several concerns: controlling the heart’s rate, managing its rhythm and reducing stroke risk.
“The first modality is medicines to control the rate,” she said. “Secondly, we have medicines that control the rhythm. These are called antiarrhythmic medicines.”
Clinicians use medical guidelines to determine which patients need blood thinners to reduce the risk of stroke.
Another treatment is catheter ablation, an outpatient procedure used to treat the abnormal electrical activity responsible for AFib.
“Our gold standard treatment for AFib is catheter ablation,” Rominiecki said.
Although treatment can keep the condition under control, recurrence remains possible.
“There is no definitive cure,” she said.
Rominiecki urged people experiencing symptoms to seek a diagnosis and emphasized the value of beginning treatment early. Over time, AFib can cause structural changes in the heart, including enlargement of its left upper chamber, she said.
“We have so many tools at our disposal for diagnosis and treatment,” she said.
Her closing message was to pay attention to changes in breathing, heartbeat and general well-being, particularly among people with known risk factors or a family history.
“Early detection, early diagnosis, early treatment will vastly improve your chances for long-term success and maintenance of normal rhythm,” she said.