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Who will benefit most from this site?
Especially people who have recently been diagnosed with afib will probably find this site helpful because it offers the
perspective of one who has lived with afib, fought afib, and survived to live a normal life. In the beginning when afib is
often out of control, it can be extremely frightening; and one is often erroneously sure that death is near. The emotional
upset caused by afib ironically just worsens the afib itself by causing a faster heart rate, breathlessness, and other frightening
symptoms. The information on this site should help the beginning afib patient to remain calmer during episodes and thereby
reduce the intensity of the afib episode.
What can experienced afib patients hope to gain from this site?
Because afib is experienced slightly differently by each person, even persons experienced in living with afib can gain
insight and understanding from learning of the experience of others. Knowledge of new medications and procedures gained
from such exposure and interaction with other afibbers can then be discussed with one's doctor.
Is afib dangerous in any way?
The greatest danger from afib is its potential to cause stroke. Because the pumping efficiency of the heart
in afib is decreased by 33 percent, blood can pool in the heart chambers, possibly forming clots. If one of these clots
is kicked out into the bloodstream and travels to the wrong place, the result can be a stroke. For this reason, doctors
commonly prescribe an anticoagulant drug to afib patients for the purpose of thinning the blood: either aspirin or Coumadin
(Warfarin). The patient taking Coumadin must then have regular tests, called Protime tests (short for Prothrombin Time
Tests), to measure the current status of the blood's clotting potential. The number which expresses this measurement
is called the INR, the internationally accepted standard of measurement. An ideal, therapeutic INR (International Normalized
Ratio) number for most patients is between 2.0 and 3.0. In the beginning of Coumadin therapy, tests must be taken every
few days, but after the anticoagulation level stabilizes, Protime tests typically occur once a month. As long as coagulation
properties of the blood are properly monitored so that correct levels are maintained, Coumadin is a safe drug that can provide
peace of mind to afibbers through protection from stroke.
How can I tell when I am in afib?
Taking the pulse is usually an accurate way to tell if one is in afib. If the pulse is irregular and erratic, without
the normal, predictable beat sequence, it's possible that one is in afib. If the afibber is not taking medication to
control heart rate, the pulse in afib may also be very fast; but if the afibber is taking rate control medication, the pulse
can be a normal 60 - 100 beats per minute. Especially in initial afib episodes, a person may experience very noticeable,
frightening symptoms such as the feeling of movement in the chest, dizziness, shortness of breath, pounding heart beats, sleeplessness,
pain, tingling in the arms and hands, or even fainting. Some people never experience these very frightening symptoms
and may live for years with undiagnosed afib. Often the extreme symptoms described above will abate as a person grows
accustomed to afib or as medication controls them. For such people, sometimes the pulse will seem fairly regular even
when in afib, but an ECG may still show afib. Thus it is often necessary to have an ECG or to wear a Holter monitor
to find out definitively if a person is in afib. A Holter monitor is a portable device which records the electrical
activity of one's heart over a period of time ranging from 24 hours to days. Also, other monitoring devices are available
to help determine whether a person is in afib or not.
If stroke is the greatest danger presented by afib, what can I do to prevent stroke?
Because stroke risk rises with age and certain bodily conditions, your doctor will evaluate whether or not you need to
take an anticoagulant drug to thin the blood and help to prevent stroke. Coumadin (Warfarin) and aspirin are commonly
prescribed anticoagulant drugs used by afib patients to prevent stroke. Taking Coumadin means that the patient must
have a Protime test at regular intervals to measure the blood's clotting ability. The Protime test will yield a number,
called the INR, which is a measurement of the time it takes for the patient's blood to clot. The Coumadin dose will
be adjusted depending on the INR. (See above.) Also, any normal measures that promote bodily health and keep
blood pressure in check will help to prevent stroke: doctor-approved exercise, eating a heart healthy diet, and
avoiding food and drink that are known to encourage cardiovascular problems such as hypertension.
Why do I sometimes experience dizziness when I am in afib?
Dizziness can be one of the most upsetting and most common symptoms of afib, and it can arise from a variety of
sources. A too fast heart rate when afib is not controlled by the appropriate medication can cause extreme dizziness.
Slowing the heart with the right medication can remedy the dizziness. Also, too low blood pressure or a very slow heart
rate with long pauses between beats can cause dizziness, which may be controlled by changes in medication. In addition,
sometimes a medication can cause dizziness because it is the wrong one for a particular patient or because the dose is too
high or too low. Many afibbers have reported dizziness, fatigue, and breathlessness when beginning treatment with a
beta blocker, but this often disappears if the patient's doctor advises continued use of the drug and the patient is
able to work through the initial symptoms.
Should I go to the emergency room every time I have afib?
Only an afibber's doctor can offer sound advice as to whether or not to go to the emergency room for afib because this
necessity varies greatly from one person to another, depending on how the individual experiences afib. Some afibbers
never go to the emergency room while others go every time afib strikes. Certainly if unusual symptoms or symptoms of
a heart attack or other serious cardiac problems are present, it is best to be on the safe side and seek emergency evaluation.
It's a good idea to ask your doctor beforehand what to do when afib strikes if you are a paroxysmal afibber.
Will my paroxysmal afib definitely grow worse and become permanent afib?
While some doctors believe this is true, others say that if a patient has had afib for a long time and always spontaneously
converts to normal sinus rhythm, it is unlikely that the patient is definitely destined for permanent afib. In other
words, this point is controversial among doctors with whom I have spoken. This afibber has had paroxysmal (intermittent)
afib for at least 21 years, but my afib episodes have actually decreased recently in duration, frequency, and intensity as
a result of medication and changes in diet and lifestyle. Some afibbers do, however, notice an increase in afib episodes
over a period of time and opt for an antiarrhythmic drug or a procedure to counteract the progression toward permanent afib.
Should I be taking Coumadin/Warfarin or another anticoagulant to prevent stroke, a serious, possible side
effect of afib?
The answer to this question depends on many individual factors such as age of the patient, length of experience with
afib, length of individual afib episodes, and general medical condition. This question can only be answered for each
individual afib patient by that individual's doctor, who knows the the patient's entire medical background, status, and other
mitigating factors. In general, the need for anticoagulation increases as age and the length of afib episodes increase,
but no generalization can be made that applies to everyone because each case is different.
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