HCA Healthcare expert shares what you need to know about AFib

Atrial fibrillation, commonly known as AFib, is the most common arrhythmia. Those living with AFib are at increased risk for strokes, heart failure and other health concerns. Both the Centers for Disease Control and Prevention (CDC) and the American Heart Association predict that more than 12 million Americans will have AFib in 2030.

If you know someone diagnosed with AFib or suspect that you or a loved one may have it, keep reading. Dr. Jose Osorio, a board-certified clinical cardiac electrophysiologist and medical director of HCA Florida Miami Electrophysiology, explains what AFib is and shares his hopes for future treatment. As the principal investigator in several clinical trials, Dr. Osorio is researching novel treatment options for AFib.

Question: What is AFib and what does it feel like to have it?

Dr. Osorio: AFib is a type of arrhythmia that causes the upper chambers of the heart, the atria, to lose their regular electrical activity and start quivering. As a result, the heart may beat very fast and become unable to pump blood effectively, leading to a variety of symptoms. Blood can also pool in a small pouch called the appendage, where clots may form, increasing the risk of stroke fivefold. Additionally, strokes caused by AFib tend to be more severe than those resulting from other causes.

The most common symptoms of AFib are fatigue and heart fluttering. Other symptoms include:

• Fast, irregular heartbeat
• Shortness of breath
• Anxiety
• General fatigue or fatigue when exercising
• Dizziness, faintness, confusion, weakness
• Chest pain or pressure

Some people with AFib have no symptoms, which is why it’s important to have your heart checked regularly, even if you think nothing is wrong.

Question: How is AFib diagnosed?

Dr. Osorio: When I evaluate patients who possibly have AFib, I start with their medical history, physical examination and an electrocardiogram (ECG). Some patients have episodes that come and go (paroxysmal AFib) and may be more difficult to diagnose. Others will be in AFib all the time and the diagnosis is easier (Persistent AFib).

If AFib is not detected during the office visit, we commonly send patients home with a heart monitor that will record all heartbeats for a week or more. In some cases, we use implantable heart monitors to make a diagnosis.

These tests will help us diagnose and choose the best treatment options, which may include medications or procedures.

Visit the American Heart Association’s website for a downloadable, “Partnering in Your Treatment” guide that can help you discuss your heart health and options with your physician.

Question: Who is at risk for AFib, and what are the risk factors?

Dr. Osorio: Anyone can have AFib, but it is more common in individuals with the following conditions:

• Advancing age
• Alcohol use (moderate to heavy, binge drinking)
• Family history of AFib
• High blood pressure (a leading cause)
• Obesity
• Sleep apnea
• Smoking
• Underlying heart disease or other chronic conditions, such as diabetes

Lifestyle changes will help reduce your risk of developing AFib and improve control if you already have it:

• Engage in regular physical activity
• Eat a heart-healthy diet low in salt, saturated fats, trans fats, and cholesterol
• Manage high blood pressure
• Avoid excessive alcohol consumption
• Don’t smoke
• Control cholesterol levels
• Maintain a healthy weight

Question: Can AFib go away on its own?

Dr. Osorio: AFib typically does not resolve on its own. Most patients begin with sporadic episodes that become progressively more frequent and last longer. However, living a healthy lifestyle can slow the
progression of AFib and improve the effectiveness of treatments.

Question: What treatment options are available for someone diagnosed with AFib?

Dr. Osorio: Today, we have a wide range of treatment options for our patients.

The primary goals of treatment are to prevent stroke and other complications and to improve quality of life. For patients at risk of stroke, we use anticoagulants, and for those who cannot take them, we offer left atrial appendage closure devices.

We also perform procedures that can treat and, in some cases, eliminate the arrhythmia. Atrial Fibrillation ablation is a procedure where we attempt to eliminate the signals that trigger and maintain AFib. A new technology called Pulsed Field Ablation (PFA)  has revolutionized AFib ablation. PFA uses novel non-thermal energy to treat AFib without damaging surrounding tissue. It is safer, more efficient and allows us to perform the procedure under sedation instead of general anesthesia.

We also encourage patients to explore the American Heart Association’s My AFib Experience website. In this online community, individuals with AFib and their loved ones can share stories and find support.

Question: What are your hopes for the future of AFib treatment?

Dr. Osorio: In addition to traditional treatment options, ongoing innovation in the field of ablation continues to bring forward new technologies. At HCA Healthcare, we are proud to be part of several clinical trials exploring new treatments for AFib.

Currently, we are involved in nearly a dozen AFib clinical trials across the organization, with many of these studies led by me as the principal investigator. Clinical trials play a critical role in developing safe and effective treatments for various conditions, including AFib. We are committed to advancing AFib treatment and improving outcomes for patients worldwide.