Atrial fibrillation (AFib) is a condition that causes the heart to beat rapidly and irregularly. This can lead to heart failure, which develops when the heart is not pumping blood efficiently around the body properly.
AFib is the most common form of cardiac arrhythmia, meaning it causes an irregular heartbeat. It also causes tachyarrhythmia, which is when the heart beats too quickly.
AFib is currently the leading cardiac cause of stroke, as it causes blood clots to form in the heart and may break off and travel to the brain. This process, known as paradoxical embolism, can cause a stroke.
Heart failure occurs when the heart causes blood to stop pumping effectively. It can result from any condition restricting the heart from pumping the necessary amount of blood around the body to meet its requirements.
There are two types. The systolic type develops when the muscular layer and inner layer of the heart, called the myocardium and endocardium, develop faults that stop the heart cavities from filling and ejecting blood in the way they should. The diastolic type occurs when the heart is abnormally stiff and pumps blood at high pressures.
This article explores the link between AFib and heart failure, whether one condition can cause the other, and the risk factors and symptoms of AFib and heart failure.
What is the link between AFib and heart failure?
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AFib and heart failure have close links. This is because they have common disease mechanisms and risk factors. Both can result in morbidity and mortality.
Additionally, both AFib and heart failure are increasing in prevalence. This is because many of the risk factors they share are on the rise, including:
- diabetes
- obesity
- hypertension
- underlying heart disease
- people living longer
- sleep apnea
AFib and heart failure can occur at the same time. Prognosis is generally worse when this is the case.
Treatments and monitoring strategies are also similar for the two conditions. However, the co-occurrence of both conditions can complicate treatment. By looking out for the features of one condition, it is often likely that signs and symptoms of the other will also be evident.
Can AFib cause heart failure?
AFib can cause heart failure. AFib can affect blood pressure numbers, affecting the function and health of the heart.
A person with AFib is three times more likely to develop heart failure.
Can heart failure lead to AFib?
As well as AFib causing heart failure, heart failure can also cause AFib. AFib can result from any condition that affects the anatomy of the heart by causing:
- inflammation
- stress
- damage
- ischemia (inadequate bloody supply to the heart muscles)
Heart failure can cause all of these mechanisms to occur.
Additionally, heart failure causes structural and neurohormonal changes that increase the risk of developing AFib.
Risk factors for AFib and heart failure
AFib and heart disease share most of their risk factors. These include:
- high blood pressure
- smoking
- obesity
- diabetes
- sleep apnea
- coronary artery disease
- older age
AFib and heart disease can also be risk factors, as having one of the conditions increases the risk of developing the other.
Treatment for AFib and heart failure
There are several treatment options for AFib and heart failure. If a person has both conditions, a healthcare professional may recommend certain treatments over others.
AFib treatment
Treatment for AFib aims to improve symptoms and will vary depending on whether it co-occurs with heart failure.
Medications may be used to prevent blood clots from forming, control a person’s heart rate, and regulate the heart rhythm.
If a person has AFib and heart failure, then a doctor may advise medications that control the heart’s rhythm rather than heart rate control.
If a person with AFib does not respond to medication then surgery may be necessary. If they also have heart failure, a surgeon may be more likely to recommend a catheter or surgical ablation, which destroys or removes the tissue causing the irregular heartbeat.
Heart failure treatment
The damage that occurs to a person’s heart from this condition can be permanent. However, several treatments can improve symptoms and quality of life by keeping heart failure under control.
Several medications can treat the symptoms of heart failure. These include ACE inhibitors, MRAs, SLGT2 inhibitors, anticoagulants, and beta-blockers.
If a person does not respond to medication, then surgery is an option. Surgical options will vary depending on the cause of heart failure and include fitting a pacemaker, cardiac ablation, heart valve surgery, or in some cases, a heart transplant.
When to speak to a doctor
A person should speak with a doctor as soon as possible if experiencing symptoms of AFib or heart disease, even if they seem minor.
AFib symptoms
This includes the following symptoms of AFib:
- intermittent chest pain or discomfort
- a sudden change in heart rate
- a consistent heart rate of less than 60 BPM or more than 100 BPM, if this is not expected for a person
- fatigue
- breathlessness, particularly during exercise
- heart palpitations
- uneasiness
Heart failure symptoms
Symptoms of heart failure can be less obvious, including:
- shortness of breath
- difficulty breathing when lying down
- waking up from shortness of breath
- fatigue
- swelling
- stomach expansion
- stomach pain
- weight gain
Because many of these symptoms do not relate directly to the heart, it can be harder to make the association. The British National Health Service (NHS) suggests seeing a doctor if symptoms are present.
Heart attack symptoms
It is important to take caution when experiencing any heart symptoms. The following features of chest pain may indicate AFib. However, they may be a sign that a heart attack is taking place.
Seek immediate medical attention if a sudden chest pain develops that:
- lasts over 15 minutes
- makes the chest feel heavy or tight
- spreads to the jaws, arms, legs, or back
- occurs alongside feelings of breathlessness, sweating, feeling sick
Summary
Atrial fibrillation, or AFib, and heart failure are both increasingly prevalent heart conditions that restrict the blood from flowing properly, disabling necessary functions in the body.
AFib can lead to heart failure, as it causes the heart to beat irregularly and too quickly. The reverse can also occur, as the mechanisms that cause heart failure can lead to AFib.
It is important to see a doctor whenever a person suspects a heart condition, as with a diagnosis, it is much easier to establish a treatment plan. Always seek immediate medical attention if severe chest pain that may indicate a heart attack develops.
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