Is AFib an Emergency Situation?

Any sudden changes to your heartbeat can be frightening and physically overwhelming. If you’ve been diagnosed with atrial fibrillation (AFib), you may be familiar with the feeling. But it’s still hard to tell if you’re experiencing a medical emergency or if you can safely manage an episode of AFib at home.

AFib happens when the upper chambers of the heart beat too fast. You may feel fluttering in your chest, lightheadedness, your heart racing, or like you can’t get enough air. Other people feel fatigued, and some people with AFib experience no symptoms. Rarely, patients may experience loss of consciousness. These symptoms and AFib attacks can come and go or remain persistent.

Regardless of your symptoms, this serious medical condition requires diagnosis, treatment and lifestyle management.

AFib complications and risks

AFib typically isn’t life-threatening for otherwise healthy people.

But, if you are older or have risk factors like diabetes, high blood pressure, or other heart diseases, AFib can lead to stroke. Because blood clots can form in the heart’s upper chambers and travel to the brain, AFib is a major cause of stroke.

If your heart rate is not well controlled, AFib can affect your heart function, leading to heart failure.

Rarely, people with AFib develop serious medical issues, including heart attack and life threatening arrhythmias.

Should you go to the emergency room for AFib?

Once you’re diagnosed with AFib, your doctor can help you determine if and when you should seek emergency medical care for this condition.

Recognizing severe AFib signs

Immediately go to an emergency room if you experience the following:

• symptoms of a stroke (including sudden limb weakness, numbness, difficulty speaking or seeing, or mental confusion/disorientation)
• marked shortness of breath or difficulty breathing
• chest pain
• marked dizziness, lightheadedness, or loss of consciousness
• persistent, marked symptoms

Managing AFib

“AFib requires a multidimensional approach to evaluation and treatment,” says Jeffrey Goldberger, M.D., M.B.A., director of the University of Miami Health System’s Center for Atrial Fibrillation.

“First, we assess and address each patient’s risk factors and underlying health conditions that may have led to AFib,” he says. This approach helps patients manage chronic conditions including obesity, diabetes, high blood pressure and sleep apnea — which can greatly improve their AFib outcomes.

Your disease management and risk reduction plan may include:

• weight loss
• taking medications as prescribed or modifying your prescriptions/dosages
• getting more physical activity
• following a heart healthy diet
• quitting smoking
• disease monitoring through bloodwork, a blood glucose monitor, consultations with your cardiologist
• limiting or avoiding alcohol
• reducing stress
• improving sleep quality, using a CPAP machine, if recommended

Reaching and maintaining a healthy weight is proven to reduce AFib symptoms and severity.

“We recently completed a study that evaluated the added benefit of taking liraglutide, a GLP-1 receptor agonist medication,” Dr. Goldberger says. “This medication promotes weight loss and helps shrink the fat tissue around the heart that triggers AFib. This approach may help prevent recurrent AFib in patients undergoing catheter ablation. Treatment with this class of medications, now approved for weight loss, offers a novel approach to help control risk factors and improve outcomes in patients with AFib.”

In combination with risk factor management, AFib treatment options include:

• medications to prevent blood clots and/or control the heart rate/maintain normal heart rhythm
• the non-surgical ablation procedure, which uses a variety of energy sources (radiofrequency, cryotherapy, laser, or pulsed field ablation) to interrupt the pathways that cause AFib
• surgical ablation
• non-surgical cardioversion treatments, which use electric shock to reset the heart to a normal rhythm (cannot prevent recurrent AFib episodes)

Why should you choose UHealth for AFib treatment? 

UHealth patients have access to the following novel treatments for AFib:

The MAZE procedure is approved for patients who have had ablation in the past, but AFib returned, as well as those having cardiac surgery for another reason. With this surgical procedure, UHealth surgeons use incisions or ablation (radiofrequency or cryotherapy).

UHealth’s team has developed a novel mapping technology called Electrogram Morphology Recurrence to help identify sources of AFib that should be ablated. “The EMPIRE-AF study will evaluate the potential for this new technology to successfully identify the drivers for each patient’s AFib,” Dr. Goldberger says.

The UHealth AFib team is developing novel approaches for stroke prevention in AFib. Using a specialized cardiac MRI technique called 4D flow MRI, the team can look inside the heart to identify areas of poor blood flow that may lead to the formation of blood clots and increase stroke risk. “The CINEMAS study is in progress and will evaluate the clinical utility of 4D flow MRI,” he says.

The Watchman device is designed for AFib patients with a significant risk for stroke who are not candidates for anticoagulation therapy. The device is implanted through the vascular system to close off the upper left chamber of the heart to prevent blood pooling, thus lowering the risk of stroke.

“The UHealth AFib team, working with our engineering colleagues, is unlocking the complexities of the standard electrocardiogram (ECG) in AFib,” Dr. Goldberger says. “We aim to provide important physiologic and prognostic information about your AFib. Our overall goal is to better understand for each patient why they developed AFib and then to choose the best matching treatments.”

Contact UHealth to schedule an appointment. Call 305-243-5554 or request an appointment online.

Dana Kantrowitz is a contributor for UHealth’s news service.

Originally published on: January 30, 2023

Tags: atrial fibrillation emergency symptoms, Dr. Jeffrey Goldberger, electrical signal, heart attack, irregular heartbeat, resting heart rate, risk of stroke, symptoms of atrial fibrillation, when to seek ER for AFib