By Joseph Hanna
IF YOU’VE RECENTLY been told by your
doctor that you have a condition called atrial
fibrillation (aka afib), you’re not alone. It’s the
most common type of arrhythmia, affecting
an estimated 2 to 6 million Americans.
An arrhythmia is a problem with the
rhythm or rate of your heartbeat. While some
people with afib experience no symptoms at
all, others may have a fast irregular heartbeat,
heart palpitations, chest discomfort and dizziness. Although it’s usually not life threatening,
it can increase the risks for a stroke and other
complications. Having afib can be scary at
first, but there are actions you can take to
manage your condition and lower your risks.
Normally, the heart beats at about 60 to
100 beats per minute and in a regular pattern
(known as sinus rhythm). This is controlled
by the heart’s built-in electrical system. The
electrical impulses are generated by the sino-atrial (SA) node, a cluster of cells located at
the top of your heart, also known as the body’s
natural pacemaker. As the electrical signal
spreads from the SA node to the bottom of
the heart, it stimulates the heart muscles to
squeeze and relax, creating the heartbeat.
With afib, a disturbance in this electrical
system causes the heart to beat too fast and in
a disorganized manner. While in many
instances the cause of afib is unknown, the
older you are and the more medical conditions (such as heart disease) you have, the
more likely you are to be at risk for this condition. For some people, certain triggers, such
as exercising too hard or drinking too much
alcohol, can trigger an episode.
Afib may occur infrequently or it may be
an ongoing, lifelong condition. Depending on
your symptoms and risks, you may be prescribed something from the following classes
• Antiarrhythmics, such as amiodarone,
to help maintain a normal heart rhythm. In
some cases, a controlled shock to the heart
• Heart-rate controllers, such as beta block-
ers (e.g., metoprolol), to slow your heart rate.
Because afib causes the heart’s upper
chambers to quiver and not pump blood efficiently, blood can collect and form a clot. This
clot can travel to the brain, causing a stroke.
About 15 percent of all strokes are due to afib.
Blood thinners (e.g., baby aspirin) or anticoagulants (e.g., warfarin) are often prescribed
to most people with afib to reduce their risk of
having a stroke.
For these medications to work effectively,
they should be taken exactly as prescribed.
Antiarrhythmics and warfarin often interact
with other medications, including over-the-counter medicines. Always talk to your pharmacist before starting a new medication,
including natural health products.
Your risk of having a stroke with afib can
be estimated using a common scoring tool
called the CHADS ( mdcalc.com, search
“CHADS”), which looks at your history of
congestive heart failure, hypertension, diabetes, stroke symptoms and age. It is based on
several risk factors and is often used to determine whether you will need a blood thinner
to reduce your risk for stroke. Ask your doctor or pharmacist about calculating your risk.
Many people living with afib are able to
maintain regular, active lives. Knowing more
about this condition
and how it’s managed
will help you to live
with it and lower
your risk for future
Joseph Hanna, B.Sc.
Phm., CDE, CGP,
is director of Costco
Pharmacy in Canada. Joseph Hanna
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