AFib: Myth versus fact

Separating fact from fiction makes all the difference in AFib treatment

Atrial fibrillation, often referred to as AFib, is the most common heart rhythm disorder, but it’s also one that’s often misunderstood.

AFib is a serious, progressive disease with no cure that affects people of all ages. Misconceptions can delay diagnosis and keep you from getting the care you need to live a full, healthy life.

Faiz Subzposh, MD, a cardiac electrophysiologist at Geisinger, separates fact from fiction, so you can recognize AFib symptoms, understand risks and know when to seek care. Because getting in sync with your doctor helps you make informed decisions about effective AFib treatment and management.

What is AFib?

AFib is the most common form of heart arrhythmia, or irregular heartbeat. It causes the heart’s upper chambers to beat irregularly and many times, extremely fast, due to faulty electrical signaling. The heart’s upper chambers beat out of sync with the lower ones, disrupting blood flow to the lower heart chambers and the rest of the body.

Left untreated, AFib can cause blood to pool and lead to blood clots, stroke and even heart failure. It also can weaken the heart muscle, making it difficult to pump enough blood to your organs.

“AFib episodes can occur irregularly or consistently,” says Dr. Subzposh. “But in either case, it should always be treated to reduce stroke risk and other heart-related complications.”

AFib: Myth vs. fact

Early evaluation leads to better outcomes — and misinformation might be one of the biggest threats to your heart health.

Here, Dr. Subzposh debunks 6 common misconceptions about AFib:

Younger people don’t get AFib

It’s true age is the greatest risk factor for AFib, and most people develop it after age 65. But younger adults can be affected, too. A family history of AFib, obesity, heavy alcohol use, untreated sleep apnea or uncontrolled diabetes can increase the risk in younger people.

“Addressing modifiable risks early — like weight management, sleep optimization and limiting alcohol — can reduce episode frequency and may delay progression from occasional to persistent AFib,” says Dr. Subzposh.

AFib symptoms are always noticeable

Some people detect AFib symptoms right away, while others have subtle symptoms or none at all. In fact, some people may have AFib and not even know it.

But in most cases, people have these AFib symptoms:

An irregular heartbeat
Heart palpitations, like a fluttering sensation or racing heartbeat
Chest discomfort or pressure
Shortness of breath
Dizziness and fainting
Weakness and fatigue

“AFib can cause no symptoms at all, but you still need treatment to prevent a stroke,” says Dr. Subzposh. “Even brief or infrequent AFib episodes can carry risks of blood clots and stroke.”

That’s why routine cardiac assessments are important to know for sure if you need prompt treatment.

If I only have 1 episode of AFib, it likely won’t return

Some people can have a single episode of AFib, like if they were unusually sick with an infection or had surgery that led to a postoperative episode. However, they’re still at risk for long-term AFib.

There is no cure for AFib and it tends to be a progressive disease that requires lifelong treatment to minimize symptoms and complications. At first, episodes may be sporadic and go away on their own. But over time and without treatment, they can become stronger, more frequent and last longer.

Electronically shocking the heart can stop AFib for good

Cardioversion, or electronically shocking the heart, can reset the heart back to normal rhythm for most people. However, it doesn’t guarantee their rhythm will remain that way. Treatment is necessary to minimize the risk of AFib returning.

Medication is usually the first line of AFib treatment to help control the heart’s rhythm, slow it down and prevent blood clots from forming. But it typically doesn’t prevent all episodes.

Over time, medication can become less effective and additional treatment, such as a catheter ablation, may be necessary to relieve symptoms and frequency of episodes. Catheter ablation is a surgical procedure that destroys the abnormal tissue near your heart that could cause the irregular heart rhythm.

If catheter ablation is successful, I can stop medications

For some people, a successful catheter ablation can reduce or even eliminate the need for medications that control the heart’s rate and rhythm, and sometimes blood thinners. But for most patients, blood thinners are still necessary to reduce the risk of stroke.

“The determination of whether medication is still necessary following a successful ablation procedure is highly individualized, based on your doctor’s assessment of your overall stroke risk,” says Dr. Subzposh.

It’s not safe to exercise with AFib

“Some people fear exercising can raise their heart rate to dangerous levels because they already have a resting heart rate that’s too high,” says Dr. Subzposh. “But in fact, exercise strengthens the heart muscle and can reduce frequency of episodes.”

In fact, one study found no correlation between physical activity and increased incidence of AFib. Just be sure to talk with your cardiologist first to discuss a safe and effective exercise regimen.

Exercise is an important lifestyle change for AFib treatment, along with:

Quitting smoking
Avoiding alcohol or drinking in moderation (no more than 2 drinks a day for men; 1 drink a day for women)
Staying hydrated and limiting caffeine
Maintaining a healthy weight and eating a heart-healthy diet
Managing chronic conditions like diabetes, high blood pressure and sleep apnea
Reducing stress

“Combining lifestyle changes with medical therapies can reduce episodes and improve outcomes,” says Dr. Subzposh. “With the right plan and regular monitoring, many people reduce AFib symptoms, lower stroke risk and feel more confident staying active.”