Is Atrial Fibrillation/Afib Inherently Dangerous?

When we discuss the urgency of atrial fibrillation treatment, we must distinguish between the dangers of Afib itself – in other words, how dangerous a fast, erratic beating or quivering heart is versus the concern surrounding the consequences of untreated or under-treated Afib. This article will help you understand why Afib should be treated promptly and what to expect.

Dangers Associated With Afib Itself

By and large, atrial fibrillation is not a deadly condition in and of itself. The heart can beat double the speed it should due to the chaotic, quivering associated with Afib versus a standard rhythmic heartbeat. Yet, the fast heartbeat will likely not cause immediate major cardiovascular events. With that said some patients with severe cardiovascular issues may be susceptible to a cardiac event if they develop Afib.

The most significant issue associated with Afib itself is intense discomfort. While minor episodes may feel like a quick flutter or thumping heartbeat, severe episodes can feel like a heart attack and even be debilitating. Many patients, therefore, end up in the ER, where they receive their initial Afib diagnosis. Afib can also cause several symptoms, not least chronic fatigue, that can sideline patients in their everyday lives.

The Consequences of Untreated Afib

The consequences of untreated or undertreated Afib are where the actual problem lies. When Afib first appears, it is typically paroxysmal or occasional. These pauses between episodes give many patients a false sense of security – maybe I don’t need to address this… perhaps nothing is wrong. However, Afib is a progressive condition, and eventually, it will become persistent and even long-standing persistent. These stages of Afib are significantly more challenging to treat and, in some cases, cannot be treated effectively with medications or procedural interventions like cardiac catheter ablation.

From a cardiovascular standpoint, the erratic beating of the heart can also increase stroke risk by up to five times due to a small pouch in the left atrium of the heart known as the Left Atrial Appendage. Rhythmic heartbeats usually empty the blood from this small outpouching, but the chaotic beats of Afib can cause blood to pool and clot. If a clot dislodges, it can travel to the brain, where it causes a stroke. We, importantly, stratify risk in every Afib patient to understand if they need antithrombotic medication, colloquially known as blood thinners, to reduce this stroke risk.

The likelihood of congestive heart failure also increases dramatically with untreated or undertreated Afib. The heart is working significantly harder than it should because of the excessive heartbeats, and this can cause the muscle to enlarge just like any muscle would if we were working out in the gym. However, the constant heartbeat does not allow the heart muscle to relax, eventually making it weaker, not stronger. Congestive heart failure is a chronic and progressive concern that reduces the heart’s pumping ability, ultimately leading to severe disability and death.

The Bottom Line

So, as you can see, Afib may not be the most dangerous arrhythmia, but its consequences can be significant. With a continuing epidemic of excess weight and obesity in the United States, Afib is becoming more prevalent and will begin to affect more and younger populations. While Afib is not a well-known condition, it should be on everyone’s radar, as early detection can lead to effective treatment and reversal of symptoms, while late treatment can lead to fewer treatment options.

For more information, or if you have been diagnosed with Afib at the hospital or by your primary care physician but don’t know what to do next, we encourage you to contact our office and schedule a consultation with Dr. Tordini to learn more.

Related Topics:

• Is Afib Dangerous?
• Comparing Cardiac Catheter Ablation Success During Paroxysmal Versus Persistent and Long-Standing Persistent Afib

Dr. Tordini is a part of Florida Medical Clinic Orlando Health