Living with Atrial Fibrillation: Prognosis and Insights
Atrial Fibrillation (A-fib) is a common type of irregular heart rhythm, affecting approximately 2.7 million people in the United States. This condition, characterized by the heart's upper chambers quivering due to irregular electrical activity, is associated with an increased risk of sudden death and cardiovascular diseases.
People with A-fib and heart failure, a condition that increases the risk of developing A-fib, have a poorer outlook. In fact, the presence of both conditions doubles the mortality risk compared to heart failure alone [1]. This risk is particularly high in heart failure with preserved ejection fraction (HFpEF) due to atrial stiffness and fibrosis [1].
High blood pressure, structural heart diseases such as valve diseases, cardiomyopathy, past heart attacks, and congenital heart defects, also contribute to the onset and poorer prognosis of A-fib [2][3]. Other systemic conditions like thyroid diseases, obstructive sleep apnea, diabetes, chronic kidney and lung diseases also elevate the risk and negatively affect outcomes [2][3].
Lifestyle and external factors, such as excessive alcohol intake, caffeine, smoking, drug abuse, severe stress, and advancing age, influence both the development and severity of A-fib and thereby affect survival [2][3]. Genetics and family history also play a role, with up to 30% of A-fib patients having affected relatives [5].
Comorbidities such as hypertension and diabetes significantly negatively affect the life expectancy of a person with A-fib. A-fib increases a person's stroke risk by about five times, and strokes caused by A-fib are often more severe than those caused by other underlying causes [4].
Effective treatment and risk factor control are crucial to improving outcomes and longevity in individuals with A-fib. Healthcare professionals may aim to prevent thromboembolism, the formation of blood clots that can travel to the brain and cause stroke, or to other organs and cause complications. This can be achieved through anticoagulant medications.
Several medications can help with A-fib by preventing and treating blood clots, managing the heart's rate and rhythm, and include anticoagulant drugs, beta-blockers, calcium channel blockers, and rhythm control medications. Doctors may also recommend lifestyle changes to reduce a person's risk of complications associated with A-fib, such as maintaining a moderate weight, exercising, quitting smoking, managing stress, eating a heart-healthy diet, and avoiding alcohol and stimulants [6].
It's important to note that older people are at a higher risk of developing A-fib, but studies show an increasing trend of deaths in young adults due to factors like obesity, hypertension, and diabetes. A person's outlook and life expectancy depend on individual factors such as age, sex, other health conditions, the severity of A-fib, its response to treatment, and comorbidities.
In summary, life expectancy in A-fib patients depends largely on the presence and severity of coexisting heart conditions (especially heart failure), control of contributing systemic diseases, management of lifestyle factors, and prevention of complications like stroke and heart failure. Effective treatment and risk factor control are crucial to improving outcomes and longevity in these individuals.
[1] Heidenreich PA, et al. Heart failure in the United States: a science advisory from the American Heart Association. Circulation. 2013;128(18):e357–e369. doi: 10.1161/CIR.0b013e3182a0614e.
[2] Camm AJ, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2016;37(31):2893–2962. doi: 10.1093/eurheartj/ehv189.
[3] Kirchhof P, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2020;41(34):3231–3296. doi: 10.1093/eurheartj/ehaa889.
[4] Benjamin EJ, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation. 2021;143(9):e498–e550. doi: 10.1161/CIR.0000000000000953.
[5] Lip GY, et al. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a systematic review and meta-analysis of randomised controlled trials and cohort studies. The Lancet. 2006;368(9543):1479–1493. doi: 10.1016/S0140-6736(06)69037-3.
[6] American Heart Association. Preventing atrial fibrillation. [online] Available at: https://www.heart.org/en/health-topics/arrhythmia/atrial-fibrillation/prevention-of-atrial-fibrillation [Accessed 26 March 2023].
- Atrial Fibrillation (A-fib) is often linked to an increased risk of cardiovascular diseases and sudden death.
- Individuals with A-fib and heartfailure have a poorer prognosis, with double the mortality risk compared to heart failure alone.
- High blood pressure, valve diseases, past heart attacks, and cardiomyopathy are common contributors to A-fib.
- Thyroid diseases, obstructive sleep apnea, diabetes, chronic kidney and lung diseases also raise the risk of A-fib.
- Excessive alcohol intake, caffeine, smoking, drug abuse, severe stress, and advancing age influence the development and severity of A-fib.
- A-fib patients with affected relatives may have a genetic predisposition to the condition.
- Comorbidities like hypertension and diabetes negatively affect the life expectancy of A-fib patients.
- A-fib increases a person's stroke risk by about five times, and strokes caused by A-fib tend to be more severe.
- Anticoagulant medications help prevent thromboembolism and blood clots in A-fib patients.
- Beta-blockers, calcium channel blockers, and rhythm control medications can also aid in managing A-fib.
- Lifestyle changes, such as maintaining a moderate weight, exercising, quitting smoking, managing stress, eating a heart-healthy diet, and avoiding alcohol and stimulants, are recommended to reduce A-fib complications.
- Older people have a higher risk of developing A-fib, but young adults are increasingly at risk due to factors like obesity, hypertension, and diabetes.
- Atrial Fibrillation severity, treatment response, and individual factors like age, sex, and comorbidities influence a person's outlook and life expectancy.
- Strong control of comorbidities, especially heart failure, systemic diseases, and lifestyle factors, is crucial to improving A-fib outcomes.
- Prevention of complications like stroke and heart failure is essential for A-fib patients' longevity.
- Aq, a medication, is not mentioned in the context of treating A-fib in the provided resources.
- Psoriasis, a skin condition, may not directly worsen A-fib, but controlling diabetes, a comorbidity, and other contributing factors is recommended.
- Data-and-cloud-computing is not directly discussed in relation to A-fib management.
- Investing in businesses that prioritize health-and-wellness initiatives could indirectly help reduce the incidence of A-fib and other chronic diseases.
- Personal-finance management, such as saving for medical expenses, can help alleviate financial stress in managing A-fib and related comorbidities.
- Effective treatment and management of chronic-diseases like diabetes, COPD, and obesity can positively impact the treatment of A-fib.
- Maintaining cardiovascular-health through exercise, a heart-healthy diet, and quiting smoking can reduce the risk of developing A-fib.
- Science plays a crucial role in understanding A-fib, its causes, and developing effective treatments.
- A-fib treatment guidelines are updated periodically, such as the ESC Guidelines for the management of atrial fibrillation.
- Learning about sports like football, baseball, hockey, golf, basketball, racing, tennis, mixed-martial-arts, and sports-betting, while not directly related to A-fib, could help in managing stress and maintaining a healthy lifestyle.
- Weather conditions, while not directly linked to A-fib, can affect mental-health and stress levels, which may impact A-fib severity and management.
