Q. Can I exercise while I am in AFib? Is there a specific heartrate at which I should stop exercising?

A. During AFib the erratic fluttering of the atria can lead to a dangerously high heart rate or sudden drops in blood pressure, which can cause you to pass out and/or experience heart failure. If you have other heart problems besides AFib, exercising can worsen those symptoms. In general, if you’ve been diagnosed with AFib you should be careful to limit your exercise to moderate or mild intensity and always choose activities in accordance with your doctor’s recommendations.1 Once your AFib is under control through proper medical management and supervision and you are not experiencing symptoms you can discuss returning to unrestricted activity levels with your doctor.

It’s also worth noting that, if you do not currently have AFib and wish to increase your chances of preventing it, regular exercise is a very good method. A large observational study followed 40,000 women over the age of 50 for 12 years and found that those who exercised more than 4 hours per week had 15% lower risk of developing AFib.2 As a word of caution, too much exercise can work against you and raise your risk for AFib. This has been observed in endurance athletes who regularly engage in lengthy sessions of intense exercise.3

Q. Are there supplements I can take to help with AFib?

A. There are some supplements that may be helpful for reducing symptoms of AFib in some patients. Your doctor can advise you on which supplements might be appropriate for you and the right dose to take for your individual needs.

  • Preliminary studies have found that supplementing with omega-3 fatty acids, such as those found in fish oil and flax seeds, walnuts and certain other food sources may help decrease risk of cardiovascular disease.4
  • Potassium may be helpful as a supplement, particularly if your levels are low or you are not absorbing sufficient amounts from your diet. Essential for maintaining fluid balance, blood pressure and nerve and muscle function, insufficient potassium can cause heart arrhythmia.3
  • In a study that sought to reduce risk of atrial fibrillation following heart surgery, researchers found that patients who were given antioxidant supplements prior to surgery experienced significantly lower rates of AFib. The supplements used in the study included vitamin C, N-acetylcysteine, and polyunsaturated fatty acids.5

Q. If I don’t want to take heart rate or heart rhythm drugs because of their toxic effects what are my other options?

There are non-drug options for treating AFib, including catheter ablation.

Q. Is there a way to stop AFib when it occurs?

A. There is no self-administered intervention or method for correcting atrial fibrillation while it is occurring. If you have intermittent bouts of AFib, the symptoms will stop on their own after several minutes or hours. If your AFib is categorized as persistent your heart rhythm will not restore itself to normal on its own and will require medication, catheter ablation or surgery.6

Learn more about these treatment options.

Q. What are the potential costs associated with AFib treatment?

A. Prescription medication costs for AFib vary widely and some can be quite expensive.7 Your out-of-pocket costs will depend upon your insurance, co-pays, availability of generic options and other variables. One recent study found that costs incurred by AFib patients with Medicare average $670 per year. 8

When considering costs of managing AFib with medication it is important to consider that medication is a lifelong therapy with ongoing costs that are likely to increase over time. Adhering to a daily medication schedule can present challenges on its own. Missing doses or delays in getting prescriptions filled can lead to health consequences, some of which can be quite serious. Additionally, prescription therapy may come with side effects from the drugs, which would likely mean going through multiple types of drug therapies to find one that works for you. This can add to your cost and potentially increase your risk for health complications.

Catheter ablation costs in the U.S. range between $16,000 and $52,000.9,10 Here again, your out-of-pocket costs will depend upon your health insurance. Catheter ablation, however, is a one-time expense and may lead to improving your overall quality of life.10

Q. Will insurance cover AFib treatment?

A. Private insurance coverage will vary depending upon your individual policy. If your doctor’s prescription for certain medications or request for catheter ablation is initially denied he or she may need to go through an appeal process on your behalf.11

If you have Medicare, your prescription plan will cover certain AFib drugs, though each plan may vary slightly with regard to their preferred drug lists. Medicare may also cover catheter ablation or surgery. Depending on which procedure is recommended for you, your doctor will seek pre-certification from Medicare. If the request is denied there is an appeals process that may be successful at obtaining approval for your procedure. Failing that, don’t despair, there are secondary appeal channels through Medicare, individual state health insurance assistance programs and the Medicare Rights Center.11

Q. Will my quality of life be affected by AFib?

A. Having atrial fibrillation can negatively affect your quality of life. One study showed that even as many as one-third of patients who do not experience overt symptoms or are unaware that they have AFib report lower scores on quality of life questionnaires than their counterparts without AFib.12 On the other hand, managing atrial fibrillation will considerably improve your quality of life.10

You may be prescribed several different medications, each with its own dosing schedule and side effect profile. For these reasons, using medications for AFib may cause further health problems. Medications, for most patients, are the most helpful form of treatment. However, many studies show that patients often stop taking medications because of side effects or their own belief that they no longer need it.13

Catheter ablation for AFib has a success rate between 60 percent and 85 percent.14 Results can depend on how long you’ve had AFib prior to having the procedure. In some instances, a second catheter ablation procedure is performed in order to achieve satisfactory results. A study published in the January 2018 New England Journal of Medicine found that AFib patients who opt for catheter ablation live longer and require significantly fewer hospitalizations than those who manage their AFib with drug therapies.15

Q. Will I have to deal with AFib the rest of my life?

A. How long you will have to deal with AFib depends upon a number of factors such as the underlying cause, the type of AFib you have, and the type of treatment you choose.16 For some patients, particularly those without noticeable symptoms, a simple blood thinner is all that is needed to manage the condition and allow the person to live a full, normal life. For others, heart rate and rhythm regulating medications, catheter ablation, or surgery may be necessary and symptoms may persist to varying degrees or may resolve completely and permanently.

Success rates for catheter ablation surgery, meaning symptom-free without the need for drugs, historically was around 50-70% or more and with continued improvement in techniques some reports are now describing 80-85% success for first ablations and 95% when the procedure is repeated a second time.17

Q. What lifestyle changes will I have to make if I’m diagnosed with AFib?

A. Your lifestyle is made up of series of choices you make on a daily basis and is largely under your control. One of the most helpful actions you can take to help manage AFib is to evaluate your diet and improve it where indicated to make it as heart-healthy as possible. That means replacing sodium with low-sodium spices and trading saturated fats for foods that are low-fat or contain unsaturated fats, for starters.18

If you are a smoker there is no better time than now to quit smoking for the betterment of your health. Smoking is bad for your heart and blood vessels in many ways. It increases your blood pressure, causes atherosclerosis (hardening of the arteries), impairs your heart function and damages your blood vessels, all of which can worsen AFib symptoms and make the condition more difficult to manage.19

Alcohol is known to trigger episodes of atrial fibrillation, even at low doses, so limiting and, ideally eliminating alcohol, is a lifestyle change that will make a positive difference for you.18

Stimulants such as caffeine raise heart rate and can trigger an episode of paroxysmal AFib or worsen your symptoms if you have persistent AFib. Its best to avoid coffee and other caffeine-containing foods and beverages such as energy drinks, soda, and chocolate.18

Moderate exercise, within the guidelines set for you by your doctor, will strengthen your heart and make it, and you, more resilient. Exercise can also help improve your mood and outlook as well as help to decrease any anxiety you may experience as a result of having AFib.18

Q. What are the treatment options for AFib?

A. Learn more about AFib treatment options in the next section.

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