Answers to Common Questions About AFib

With nearly 6 million Americans suffering from atrial fibrillation, or AFib, and 150,000 new cases diagnosed each year, AFib is the most common type of arrhythmia affecting people.

Diagnosing and managing atrial fibrillation is a cornerstone of my practice at the University of Chicago Medicine, and I know that educating our patients to understand and recognize AFib is important to prevent progression of the disease. Our care team can work with you to find a treatment that offers effective relief and long-term improvement.

What is AFib?

In the simplest words, AFib is a problem with the electrical signals of the heart. AFib occurs when the heart’s upper chambers develop an abnormal, rapid, erratic heartbeat. If untreated, it can lead to poor blood flow to and from the heart, ultimately causing stroke or heart attack.

What are the symptoms of AFib?

Heart palpitations are the most common symptom associated with AFib. There are several different types of palpitations with sensations ranging from a skipped or "extra" heartbeat to a pounding or racing feeling in your heart. One thing to keep in mind is when you are having AFib, it is typically fast, and it feels uncomfortable through the duration. While heart palpitations are typical, not everyone will experience any signs of atrial fibrillation.

Does AFib get worse over time?

Atrial fibrillation can progress, making you feel worn out and fatigued with daily activities that you used to be able to do without difficulty. For example, you might get winded walking up a flight of stairs or feel lightheaded doing basic housework. AFIb can lead to serious conditions, such as heart failure, stroke or a heart attack. So, if you’re experiencing similar symptoms, it’s time to reach out to your primary care doctor to undergo testing to confirm your condition. Your physician may want an electrocardiogram (EKG) or Holter monitor to test for AFib.

What causes AFib?

We have not yet identified a single cause for atrial fibrillation, and we do not believe there will ever be one definitive cause because this condition spans all age groups, with and without heart disease. The most common source of AFib is just getting older, not people doing something wrong or having poor health habits.

Though there is no root cause of AFib, there are several risk factors and symptoms that are often seen in conjunction with the condition: high blood pressure, sleep apnea, obesity and structural heart disease. Additionally, if you have an existing condition such as heart attacks, coronary artery disease or cardiomyopathy, you are at an increased risk for atrial fibrillation. You should see your physician if you are have an irregular heartbeat, chest pain, fatigue, dizziness or shortness of breath.

How to treat AFib

Treating AFib can include a combination of heart rhythm medications, electrical cardioversion (using electrical currents to reset the heart rhythm), minimally invasive ablation procedures, implantable devices like pacemakers and surgery. Your treatment plan will be tailored to your specific symptoms and condition for the best results possible.

Our treatment plan focuses on controlling your symptoms and reducing your risk of stroke. Patients with AFib are five times more likely to have a stroke than someone without AFib, so we use blood thinners (anticoagulants) to prevent blood clots and decreasing the risk of stroke.

To treat symptoms, the goal is to either control the rate of your heartbeat or the rhythm of your heart. We use once-daily oral medications like beta blockers or calcium channel blockers to control your heart rate so you can stay in AFib but without feeling so tired. For rhythm control, we strive to restore your heart’s normal rhythm with medications or with ablation.

What is ablation for AFib? Can AFib be cured with ablation?

AFib cannot be cured, but catheter ablation can treat and control up to 70% of patients. Catheter ablation is a minimally invasive procedure that uses specially designed tubes threaded through the leg into the heart to find the source of the irregular heartbeat and eliminate it with cauterization. An ablation administers a controlled “burn” inside the heart to create scar tissue in the heart muscle which changes the electrical architecture and walls off the electrically active areas.

Ablation for AFib is typically either radiofrequency ablation, which uses heat to make the burn, or cryo-ablation, which uses cold to make a freezer burn on the heart tissue. This treatment is fast and effective, and you should be up and out of bed within 4 to 6 hours after your procedure.

Why use ablation surgery for AFib?

Surgical treatment is the best way to improve your quality of life if you have advanced or complex atrial fibrillation, such as difficult-to-control, recurrent AFib. By using surgery to control your arrhythmia symptoms, we help you live active, full lives. UChicago Medicine is unique because we have an integrated program that coordinates electrophysiologists and surgeons, so we can offer you a wide range of treatments.

A hybrid procedure that combines robotic heart surgery and standard ablation, like the innovative procedure available at UChicago Medicine, can give you relief from advanced AFib. Part of what makes our treatment unique is that we collaborate to determine a cohesive approach for patients, whether that involves a traditional endocardial ablation, an epicardial ablation, a minimally invasive robotic approach or a combination of approaches.

Gaurav Upadhyay, MD, is an electrophysiologist who specializes in detecting and managing arrhythmias, including atrial fibrillation.