AFib Guide

Don’t let AFib upset your life’s rhythm. Diagnosing, treating and living with AFib.

What brings AFIB on? Life’s pace can be frantic enough, but AFib’s irregularity is usually caused by underlying or interwoven health conditions —which become increasingly prevalent as we grow older. AFib can be an acute, chronic or risk-related condition. Let’s look at the causes that contribute to it.

Acute Conditions  Previous heart surgery or surgeries  Lung disease or infection, such as pneumonia  Asthma attacks  Heart attack

 Extreme body stress  Overactive thyroid or other glandular condition  Inflammation of the heart lining (pericardium)

Chronic Conditions  An inherited or genetic heart condition

 Excessive caffeine consumption  Excessive alcohol use  Obesity or excessive weight

 Coronary heart disease  Congenital heart defects

 COPD or another chronic lung condition  Sleep apnea (five times greater risk of AFib)

 Heart valve disease  High blood pressure  Long-term smoking or tobacco use

Risk Factors for AFib  Hypertension (high blood pressure)  Diabetes  Family history  Sleep apnea

 Coronary heart disease  Heart failure

 Rheumatoid heart (valve) disease  Congenital heart abnormalities

Diagnosing your AFib, using proven tests. One of AtlantiCare’s board-certified heart rhythm specialists can review your symptoms and heart history with you. And if needed, he or she can perform a variety of tests to monitor your heart’s electrical activity. These common testing options include: Electrocardiogram (EKG): This test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart. Echocardiogram (ECG): In this noninvasive test, sound waves are used to produce a video image of your heart in motion. The echo reflects the size and shape of your heart chambers, and tracks how well they and your heart valves are functioning. Holter monitor: This is a portable ECG device carried in your pocket or comfortably worn on a belt or shoulder strap. It continuously records your heart’s rhythms for 24 hours or longer, giving your doctor excellent insight into any problems. Zio patch: This small, wireless, water-resistant adhesive patch can record and store heart data for up to 14 days. It is also equipped with a trigger button that you can activate if you experience symptoms that suggest arrhythmia. It creates a digital time stamp for your doctor to assess. Loop recorder: This small electronic chip can be injected under the skin of the chest area to monitor your heart rhythm for longer periods — up to 2-3 years. Loop recorders are useful in evaluating how often and how long your heart remains in atrial fibrillation. Blood tests: These help your doctor rule out thyroid problems or other substances in your blood that may lead to AFib or interfere with AFib medications. Chest X-ray: These images help your doctor see the condition of your lungs and heart, and may help in diagnosing conditions other than AFib to explain your signs and symptoms.

Once it’s detected, it can be treated.

If AFib or another heart rhythm issue is detected, an AtlantiCare electrophysiologist will work with you and your primary care provider to find the right treatment to restore your normal heart rhythm. Depending on how serious your condition is, a personal plan will be developed for you, which may include the following: Medications : This is often a good first treatment option to help manage and live with AFib, especially if your symptoms are mild or infrequent. Pacemakers: Quite simply, the pacemaker paces your heart at a comfortable rhythm. It is a small device, no larger than a silver dollar inserted under the skin of your chest. The pacemaker is connected to wires that go to the heart and your Heart Rhythm Specialist sets the ideal rate for you. TheWATCHMAN™: This left atrial appendage closure device offered to select AFib patients an alternative to warfarin (Coumadin) to prevent a potentially life-threatening stroke. Cardioversion: This is a simple procedure that delivers electrical energy across your chest to restore normal heart rhythm. You can often go home right after the procedure. Ablation: This is a minimally invasive but highly effective procedure, because it targets the exact source of your heart rhythm problem. A thin, flexible wire called a catheter is threaded into a vein in your groin and guided up into your heart. The electrodes on the end of the catheter create a 3D map of your heart, allowing your physician to pinpoint the tissue that’s causing the abnormal heart rhythm. The catheter uses radiofrequency energy to treat those small areas, restoring your heart to its regular rhythm. Cryoablation: This innovative technique utilizes cold energy to freeze small areas of heart tissue to correct irregular rhythms. The process involves inserting a special balloon catheter into a blood vessel to reach the heart. There, the exact location of the disruptive electrical activity is located. Then, the balloon is inflated with coolant and placed against the targeted tissue halting the abnormal electrical signals causing your AFib.

Convergent procedure: Convergent combines the best of both traditional catheter procedures and surgical ablation to restore normal heart rhythm for long-suffering AFib patients. It is a two-part surgery that involves ablating the inside and outside of the heart. First, a cardiac surgeon makes three small abdominal incisions to send a video scope and catheter to the back of your heart. The surgeon uses radio frequency to create a maze of scar tissue thick enough to stop the electrical activity that is causing your AFib. Then, an electrophysiologist threads a catheter through your groin to reach the inside of your heart, using radiofrequency energy or liquid nitrogen to target areas that are triggering abnormal electrical signals. Can AFib be prevented? For some folks, AFib is simply not preventable. But for many of us, adopting a healthier lifestyle can contribute greatly to reducing the risk of developing AFib. Here are things you can do to better manage your health and help avoid AFib. Diet: Minimize your intake of saturated fats, trans fats and cholesterol. And be sure to eat whole grains, fruits and vegetables daily. Weight: Talk with your primary care provider about establishing an ideal weight for your age, body and build. Then work toward it. Blood pressure: Management is the key here. Establish an ideal blood pressure goal with your doctor. You may be able to maintain it through diet and exercise. Or you may need to take a beta blocker, an ACE inhibitor or another medication to reach your goal — but well-regulated blood pressure can help prevent AFib or heart disease. Sleep apnea: If you have this or another obstructed breathing symptom, it can trigger AFib. You should undergo evaluation and treatment by AtlantiCare sleep specialists to eliminate or address your condition. Physical activity: A body in motion is less likely to succumb to diseases, including AFib. Talk with your doctor about exercise and an active lifestyle. You’ll feel better and reduce your likelihood of developing AFib.

Smoking: Everyone knows that smoking puts your heart at great risk. Nicotine constricts the blood vessels, making it harder for them to deliver oxygen and nutrients to the rest of the body. To meet the need for more oxygen, a smoker’s heart rate usually increases. If you smoke, please stop. If you need help quitting, AtlantiCare offers FREE tobacco cessation classes. To register and for more information, call 609-248-9225. Watch your OTCs: Certain over-the-counter medications and caffeine products can stimulate the heart, triggering AFib episodes or increasing their frequency. Read labels carefully. Alcohol use: Minimize your daily intake of alcohol. Excessive drinking — three drinks per week or more — makes the heart susceptible to AFib.

What’s AFib, and should I be concerned? AFib stands for atrial fibrillation, a condition that can cause you to have a highly irregular or fast heartbeat. It’s very unsettling, but you’re not alone. Between 2.7 million and 6.1 million Americans are living with it right now*. And AtlantiCare has AFib experts who can help. The concern is that, if left untreated, a racing heart and related symptoms can lead to heart failure or in rare cases a heart attack. Though usually non-life-threatening, AFib is serious. Episodes may seem only temporary, but they’ll likely come back. Why is it serious? When your heart’s upper and lower chambers don’t pump in rhythm, blood pools in the upper chamber, the atria, where it is prone to form clots. If a clot were to break loose from the heart, it could travel anywhere. To your brain, lungs or other major organs, where it could lodge, block the flow of blood and likely cause a stroke that could disable or partially paralyze you. That’s why diagnosis and treatment is so important. What are the signs and symptoms of AFib? AFib can present itself as sudden or prolonged dizziness. Lightheadedness or feeling out of breath. Fainting. General weakness or tiredness. Confusion or anxiety. Heart fluttering or beating rapidly. Chest pounding or pain. Or pressure that stops you in your tracks. Bottom line, if your heart is doing flip flops, it makes sense to get it checked out right away by an AtlantiCare primary care provider or cardiac specialist. *Centers for Disease Control and Prevention

why choose AtlantiCare? Confidence, close to home.

Our board-certified physicians, electrophysiologists and cardiac surgeons are with you every step of the way. Plus, AtlantiCare offers the most comprehensive cardiac care program in southeastern New Jersey. The same level of care you’d have to drive hours to find at other health systems. Helping you return to normal. At AtlantiCare, your AFib care will be expertly guided by a knowledgeable team, who will walk you through the entire process and answer any question you might have along the way, from diagnosis through treatment to your return home. And afterward, AtlantiCare also offers the education, tools and resources you need to lead your heart-healthiest life. There’s no heart like yours. No two human hearts are alike. That’s why AtlantiCare’s personalized approach and treatment plans work so well for our AFib patients. We’re an integrated cardiac team, but we have one focus: you. The region’s premier surgery program. Should you choose us for AFib care, also know that AtlantiCare has the only full-service cardiac surgery program in southeastern New Jersey, achieving results above the state average.*

*Risk-adjusted rate, according to the Health Care Quality Assessment’s Cardiac Surgery in New Jersey 2015-2016 report

Do your heart a favor. If you think you have AFib, find and speak with an AtlantiCare physician or cardiac specialist immediately, to get the expert care your heart needs. Find your way back to a normal heartbeat, and to the rhythm of your life. To learn more or schedule an appointment, visit www.atlanticare.org/afib or call 609-451-2523.