What's to know about paroxysmal atrial fibrillation?
Paroxysmal atrial fibrillation occurs when a rapid, erratic heart rate begins suddenly and then stops on its own within 7 days. It is also known as intermittent A-fib and often lasts for less than 24 hours.
While paroxysmal A-fib is not life-threatening on its own, it can have serious consequences. As a result, diagnosing and treating the problem as early as possible is very important.
Paroxysmal A-fib occurs when there are abnormal electric pathways in the heart and the heart is not beating regularly or pumping enough oxygen-rich blood around the body.
Paroxysmal A-fib may be caused by lifestyle choices such as illegal drugs, smoking, alcohol, obesity, and excessive exercise.
It can be associated with pre-existing or previous health conditions, such as:
- previous heart attack or heart surgery
- heart disease
- sleep apnea
- high blood pressure
- lung disease
- overactive thyroid
Certain lifestyle choices can also lead to A-fib, such as:
- excessive alcohol
- other stimulants, such as caffeine and some over-the-counter medication
- illegal drugs, such as amphetamines, methamphetamines, and cocaine
- being overweight or obese
- poor sleep
- prolonged exercise
Exercise is considered a healthful habit. However, people should consult with their doctor before starting a new workout or increasing the intensity of their exercise. In some cases, increased physical exercise can also lead to A-fib due to the strain it can place on the heart.
Common symptoms of paroxysmal A-fib are:
Heart palpitations and shortness of breath may be common symptoms of paroxysmal A-fib.
- racing heart or palpitations
- shortness of breath
- dizziness or light-headedness
- fatigue or weakness
If anyone is experiencing any of these symptoms, they should contact their doctor as soon as they notice them. Even if the symptoms go away, it is important for people to have a physical examination and monitor their heart's activity.
Sometimes, there are no symptoms at all. However, a doctor will be able to diagnose the problem with a physical exam or an electrocardiogram (ECG or EKG).
An ECG is a simple test that involves having sensors attached to the skin on the arms, legs, and chest. The sensors detect electrical signals each time the heart beats. A doctor uses the signals to identify any problems. An ECG test normally only takes a few minutes.
Most cases of paroxysmal A-fib will pass naturally, but A-fib can lead to serious consequences. So, if a person experiences a change in the rhythm of their heart, they should seek medical help right away.
This is because A-fib affects blood flow around the body. Blood can become static and can clot in the upper chamber of the heart. If this is then pumped to the brain, it can clog an artery and cause a stroke.
Warning signs of a stroke:
- face drooping
- numbness or weakness of arm, face, or leg, especially down one side of the body
- difficulty speaking or understanding speech
- trouble seeing out of one or both eyes
- dizziness, loss of balance and coordination, and trouble walking
- sudden, severe headache with no known cause
There are a number of treatment options, which include:
- Rate control medication: This is the most common A-fib treatment. Its aim is to lower the heart rate to between 60 and 80 beats per minute while at rest and also regulate electrical currents.
- Rhythm control: Sometimes known as medical cardioversion, rhythm control aims to bring the heart back to a natural rhythm.
- Blood thinners or anticoagulants: Doctors may prescribe these drugs to stop the blood from clotting, which in turn decrease the likelihood of a stroke.
- Electrical cardioversion: This treatment uses an electrical current to restore the heart to a natural rhythm. This treatment aims to achieve the same goal as rhythm control medication. It is more commonly used for people who have been experiencing paroxysmal A-fib for more than 48 hours.
Doctors will often give blood thinners alongside electrical cardioversion to limit the chances of a stroke during the process.
Another procedure to treat A-fib, called catheter ablation, involves scarring the areas of the heart that are causing problems. Paroxysmal A-fib occurs when heart's electrical current reaches heart muscle that it wouldn't normally reach, which causes irregular or erratic heartbeats. Scarring the area prevents this from happening.
During this procedure, a doctor inserts thin wires called catheters into a vein in a person's neck or groin. These wires are then guided to the heart, where heated electrodes on the end of the wires scar the problem area.
A person undergoing this procedure will usually be given a local anesthetic at the area where the wires are inserted. The person is usually awake during the procedure but some people may be sedated. Most people will be able to go home on the same day, although others may be kept in overnight.
Because of the increased risk of complications occurring during surgery, doctors are likely to recommend that people who experience paroxysmal A-fib should take medication in the first instance.
Changes in lifestyle
Giving up smoking and avoiding excessive alcohol will help limit the chance of a person developing paroxysmal A-fib. People should also eat a healthful and balanced diet and try to lose weight if they are overweight or obese.
Avoiding stress as much as possible is also a good way for a person to reduce their chances of developing A-fib. Prolonged or sudden stress can link to A-fib, so limiting stress and practicing stress-relieving exercises such as yoga can help.
Living with paroxysmal A-fib
Most people with paroxysmal A-fib live normal and healthy lives, even those who require treatment. Living well with paroxysmal A-fib involves controlling the risk factors, knowing what can trigger A-fib, and working out a long-term management plan with a doctor.
Normal daily activities should not be affected with a paroxysmal A-fib diagnosis, but certain activities such as driving should be discussed with a doctor.
Here are some commonly asked questions about living with paroxysmal A-fib.
Can I exercise or have sex?
People should be able to enjoy all of their normal daily activities. While prolonged exercise can be linked with paroxysmal A-fib, moderate exercise is a good thing. People should discuss with their doctor what levels of exercise they would be able to cope with.
Regular sexual activity can be both good for the heart and help to relieve stress.
Can I drive?
Yes. Sometimes paroxysmal A-fib can cause dizziness or light-headedness, so people should always check with their doctor first.
If anyone begins to experience symptoms of A-fib, they should always pull over to a safe area at the side of the road.
Can I still drink alcohol and caffeine?
Moderate alcohol intake should be fine, but people should avoid drinking excessive alcohol. It is advised for people to try and have at least 2 to 3 alcohol-free days a week.
With caffeinated drinks, such as tea, coffee, and energy drinks, there is no strong evidence linking their consumption with A-fib. However, high caffeine intake can cause increased blood pressure, which is linked to A-fib. As such, limiting caffeine to a moderate level is also advised.
Can I travel?
If paroxysmal A-fib is being treated and is stable then there is no reason that people cannot travel and fly. However, always check with a doctor first as extreme temperatures and high altitudes can cause problems. When travelling, people should make sure they have enough medication for the entire period of their travel.
The majority of A-fib patients can get travel insurance, although the premium may be higher.
How does paroxysmal A-fib change over time?
If symptoms continue for more than a week, the condition becomes persistent A-fib. This can be treated in much the same way.
If persistent A-fib occurs more frequently, it may develop into permanent A-fib. If this happens, normal heart rhythm cannot be restored with treatment.
People should always check with their doctor if they have any concerns.