As we age, the complex biological machine that pumps blood through our bodies can misfire. If untreated, atrial fibrillation (AFib) — a kind of irregular heartbeat, or arrhythmia — can skyrocket the risk of heart failure and, especially, stroke.
Some patients may not even realize they have it, said Novant Health cardiologist Dr. Pallavi Gomadam.
“There are people who will find that they’re in AFib when they go to their primary care appointment,” she said. A physician “is listening to their heart and it sounds irregular, and they get an EKG.”
For others, AFib symptoms are more intense:
- Heart palpitations
- Heart racing
- Shortness of breath
- Loss of stamina
- Occasionally chest pain and sometimes dizziness or fainting, although that's less frequent
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How AFIB increases stroke risk
When the atria — the upper chambers of the heart — beat irregularly, blood can pool and clot. The clot can then travel to the brain, where it gets stuck and restricts the supply of oxygen.
People with AFib are five times more likely to have a stroke, and as many as 20% of stroke victims have AFib, according to the American Heart Association. The condition affected 5 million Americans in 2024. The AHA expects that number to rise sharply by 2030.
Managing AFib risk factors
Some risk factors are unavoidable, like age and genetics. But the good news is that people diagnosed with AFib can — and should — lead healthy, active lives even after diagnosis by following some common-sense practices that can counteract what Gomadam calls “reversible risk factors.”
“The most common (risk factors) that I see in my practice are obstructive sleep apnea and alcohol use,” she said. “Those are things that patients can change by limiting alcohol intake, getting a sleep study, and being compliant with their CPAP or their BiPAP if that’s what they need — those would be the most important things.
“But other risk factors are kidney disease, diabetes, obesity — we may not have control over all of those, but certainly trying to aim for some weight loss can be helpful,” Gomadam said. And trying to have better control of their diabetes by reducing their A1C (average blood sugar level) is helpful as well.”
Treatment options for AFib
Gomadam said she treats AFib patients with different procedures and medications. One common procedure is ablation, when an electrophysiologist makes small burns or freezes to the affected area to correct the irregular rhythm. She also prescribes anticoagulant medications like Coumadin, Eliquis and Xarelto to help prevent clots from forming.
What she doesn’t recommend is using AFib as an excuse to not exercise. Regular exercise can reduce your risk of worsening AFib or stroke. That’s another risk factor you can control.
You can have an active life with AFib
“It really shouldn’t be a life-limiting disease. If you’re having symptoms or difficulty exercising, that tells me we need to do more for the atrial fibrillation, not that we need to limit your activity,” Gomadam said. “We really need to treat it adequately so we don’t limit people’s quality of life.
“This is not a disease where you say, ‘Oh, I feel terrible. I’m just going to stop doing things.’ That’s not what we want,” she said. “We want you to be able to do the things that you want. So that’s a time to have a conversation with your cardiologist to say, ‘What can we do to treat it better?'”
