Looking back, Kokomo resident Mike Beatty knew he had something as a teenager, but he couldn’t put a name to it.
Whenever he’d overexert himself, he’d feel “different,” but it would go away with rest.
But when he was 30 years old and asleep one night, Beatty said that same feeling jolted him awake.
“It almost felt like my chest was pushing me off the bed,” he said. “The biggest feeling was actually in my neck.”
That was about 6 a.m. By noon, the feeling was still there, prompting Beatty to go to the hospital.
Doctors hooked him up to machines to make sure he wasn’t experiencing a heart attack.
But what he was experiencing was atrial fibrillation, or Afib for short. In Beatty’s case, his heart the day he went into the hospital had to undergo electrical cardioversion to be “shocked” back into its normal rhythm.
Paddles were secured to his chest, he said, while someone yelled “clear.”
He underwent electrical cardioversion again when he was 36.
“It saps your energy,” the now-58year-old said, describing what Afib feels like. “You have no energy. You just don’t feel like doing anything. And it’s annoying. It’s scary when you get stuck in Afib because there isn’t anything you can do.”
These days, Beatty takes medications to help control his Afib when he feels it coming on, and he said it’s just something he’s learned to live with.
And Beatty isn’t the only one. In fact, according to a recent study conducted by the University of San Francisco, Afib affects around 5% of the population, or 10.5 million Americans.
And per that study, the first of its kind in around two decades, that statistic is about three times higher than what doctors originally thought.
So is Afib really on the rise, and who is more susceptible to develop the condition? Is your heart flutter just anxiety, or is it something deeper? And what exactly is atrial fibrillation anyway?
To answer those questions, CNHI News Indiana reached out to Dr. Anil Ranginani, an interventional cardiologist with Community Howard Regional Health.
THE HEART OF THE ISSUE
To really understand the science behind atrial fibrillation, Ranginani said it’s important to understand how the heart works in the first place.
The heart has four chambers, he said, two atriums and two ventricles.
The right atrium receives oxygen-poor blood from all parts of the body and pumps it to the right ventricle, the doctor noted.
That right ventricle then pumps that blood into the lungs.
The left atrium receives that oxygen- rich blood from the lungs and then pumps it to the left ventricle, which Ranginani said then pumps that oxygen-rich blood to the rest of the body.
The heart also has several valves, which Ranginani said work like a “conduction” system within the heart, coordinating the atriums and ventricles to contract.
But during Afib — which is diagnosed via an electrocardiogram — electrical impulses occur from multiple sites in both the left and right atriums, causing them to contract several hundred times per minute.
The ventricles are then not able to keep up with the pace of the contractions, causing those ventricles to beat faster than they should and not pump blood normally.
Or simply put, an irregular heartbeat occurs.
This can be due to a congenital heart defect or a person’s lifestyle.
BEHIND THE DIAGNOSIS
And because the condition can be difficult to diagnose in its early stages due to its unpredictability, that creates a certain element of risk for the person experiencing it, Ranginani explained.
“One is a risk of stroke,” he said, “because when blood doesn’t effectively f low, it tends to clot and give you strokes. And sometimes, because of the lack of coordination between the atrium and ventricle, you tend to develop heart failure.”
“As far as the presentation is concerned, it’s variable,” Ranginani added. “Some people are very sick when they go into atrial fibrillation. Some people don’t even know they are in it.”
But there are still signs and symptoms of Afib you can watch out for, he acknowledged.
“The easiest one is fluttering in the chest or your heart racing fast without any exertion,” Ranginani said.
Others symptoms can include general fatigue, dizziness, shortness of breath, weakness or faintness and chest pain.
These days, there are simpler detection methods that can help people figure out if they’re experiencing Afib too, Ranginani said, like wearables such as smart watches.
Knowing the risk factors is important too, Ranginani added, noting other conditions like diabetes, hypertension, obesity and sleep apnea, as well as habits like smoking, can lead to a higher possibility of developing Afib.
Age also tends to play a role. “The older you are, the incidence of atrial fibrillation continues to increase,” Ranginani said. “And with overall increased longevity and an older population in our country, we’re going to see more and more of this (diagnosed cases of Afib).”
But the problem, Ranginani admitted, is that you have to essentially be in atrial fibrillation when you see the doctor or undergo an EKG that detects it for it really to be caught.
And perhaps that is what is leading to the UCSF report’s findings of underdiagnosed Afib in America, he acknowledged.
But there’s also hope for those fighting the condition now and ones that might in the future.
ADVANCEMENTS IN TREATMENT
Right now, there’s no cure for atrial fibrillation, and experts in the field say treatment is not always necessary for everyone affected by it, mainly if the Afib episodes only last for short amounts of time.
But certain treatments can help others who are consistently impacted by the condition.
Some of those include medication, cardioversion and ablation — scarring the inside of the heart to help insulate the electrical signals that cause irregular heartbeats.
But there’s also something called a loop recorder device, which Ranginani said is implanted during surgery.
That device then records a person’s heartbeat continuously for three years, though the doctor said they are predominantly used in people who have suffered strokes.
Another new advancement is called a WATCHMAN implant.
According to their website, the WATCHMAN is a onetime implant for people with non-valvular atrial fibrillation to reduce stroke risk for those who cannot take long-term blood thinners.
However, their website also states certain people — like those who cannot take medication like warfarin or aspirin — are not candidates for the WATCHMAN device.
Another treatment that just came out this year is called pulsed field ablation.
PFA, according to the American Heart Association, is approved by the Federal Drug Administration and uses electrical pulses to help restore a patient’s regular heartbeat.
But not even the best treatments match the level of just overall prevention, Ranginani noted.
“That’s where we’re lacking,” he said. “As a society, we’re not investing in prevention, which would simply be earlier intervention. We’re talking about training people from the outset. … It’s important to educate people on health span, which is basically quality of life.”
Like the idea of healthy eating and routine exercise, the doctor added.
“It’s going to improve your wellbeing, both in your mind and in your physical abilities over the longer period of time,” Ranginani said. “People need to, from a health perspective at least, put priorities of long-term goals over shortterm gratification.
“It comes back to quality of life,” he added. “You have to be able to visualize the highly physically functional 88 or 90-year-old driving by himself, taking care of himself, contributing to society, spending time with his grandchildren. That all requires work from age 20.”
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