Expert tips on living with atrial fibrillation

Atrial fibrillation (AF) affects more than 1.5 million people in the UK. But the risk increases as you get older, with 5 per cent of people aged over 45 diagnosed with it.

Shona Holding, a cardiac nurse at British Heart Foundation explains: “Atrial fibrillation can happen on its own, with the cause unknown. This is called idiopathic atrial fibrillation.

"Or conditions like high blood pressure, coronary artery disease, heart valve problems, heart muscle issues, and inherited heart conditions can trigger it. Once you’ve got atrial fibrillation, you usually have it for life.

“Many people come in and they do not have any clue they've got atrial fibrillation. As many as 30 per cent of people do not have any symptoms at all,” she says.

However, others can feel like their heart is fluttering or racing (palpitations) or may have breathlessness or dizziness.

Atrial fibrillation increases the risk of stroke

If left untreated atrial fibrillation can lead to lifechanging conditions like heart failure, or create blood clots that may lead to a stroke.

The risk of stroke is five times higher for anyone with atrial fibrillation, and increases with age and other health conditions, such as high blood pressure or diabetes.

To diagnose atrial fibrillation, your medical team will use an electrocardiogram (ECG) to record your heart’s rate, rhythm and electrical activity. After this, they will work out your risk of stroke to decide if you need treatment with a blood thinner.

They also look at how your atrial fibrillation is behaving. Does it come and go (paroxysmal) or is it permanent? How is it impacting the way your heart works? How severe are your symptoms?

Treatments range from medicines to heart procedures, such as electrical cardioversion and catheter ablation.

Devices called pacemakers, which are put in the chest region to regulate the heart rate, are also sometimes used if a person’s heart rate cannot be controlled with other treatments.

No cure for atrial fibrillation, but a healthy lifestyle helps

There is no cure for atrial fibrillation, says Ms Holding, but people with atrial fibrillation can lead healthy lives. “Healthcare professionals cannot cure atrial fibrillation. But they can treat it, control the symptoms, reduce the heart risks associated with it, and support people to manage atrial fibrillation themselves,” she says.

Research shows that adopting a healthy lifestyle is key to reducing the impact of atrial fibrillation on your life. This means eating healthily, limiting alcohol, not smoking and maintaining a healthy weight. It’s also recommended to do 150 minutes of moderate intensity exercise, such as brisk walking or riding a bike, a week.

“It’s generally safe to exercise if you are in permanent atrial fibrillation, if you feel well,” Ms Holding confirms.

“But rather than looking at your heart rate on your fitness tracker or smart watch, you should exercise to a point where you are pushing yourself, but you can still have a conversation. For those whose atrial fibrillation comes and goes, it’s recommended to only exercise when your heart is in a normal rhythm.”

She does not advise using fitness trackers and watches to track your heart rate because the irregular heart rhythm of atrial fibrillation makes the readings inaccurate.

Working out what triggers your atrial fibrillation is another important part of self-management, says Ms Holding. Common triggers include alcohol, dehydration, caffeine, spicy food, smoking and stress.

It’s important to manage your mental wellbeing

Gini Dellow, who has a health psychology background and has done research into the self-management of atrial fibrillation – a condition she has herself – says it can lead to emotional issues, as well as physical ones.

The initial diagnosis can result in high levels of anxiety, she says. “Many people I’ve spoken to for my research have told me they feared having a cardiac arrest when they were first diagnosed with atrial fibrillation.”

“Atrial fibrillation can lead to low mood too,” she adds.

“For example, people can feel they’re to blame for their atrial fibrillation. This can make them feel down and less motivated to make healthy lifestyle choices. It may also lead to stress, anxiety and depression.”

Research suggests the risks of anxiety and depression increases if you have severe atrial fibrillation, if you have had atrial fibrillation for a long time, if you do not feel informed about your health, and if you have a poor relationship with your healthcare team.

If you feel anxious, stressed, or are suffering from low mood or depression because of your atrial fibrillation, contact your medical team. Or you can try the free NHS talking therapy service.

Another way to boost your mental wellbeing, and your physical wellbeing as a result, is to feel in control of your atrial fibrillation.

“By working in partnership with your healthcare team you can find a way of living with atrial fibrillation outside the doctor’s office,” says Ms Dellow.

“Ask yourself, what can I do that might make a difference to my atrial fibrillation and wellbeing?”

Feeling more in control in this way is empowering, says Ms Dellow.

“Being able to make your own informed decisions and knowing people have got your back is really important. If you’ve got those, you’re going to feel more motivated to make lifestyle changes and have a greater level of wellbeing.”

4 tips on how to feel in control of your atrial fibrillation :

1. Understand what helps your atrial fibrillation

Try to keep to a healthy lifestyle and work out what activities relieve anxiety and boost your mood.

2. Understand what makes your atrial fibrillation worse

Working out what triggers your atrial fibrillation is another important part of self-management. Common triggers include alcohol, dehydration, caffeine, spicy food, smoking and stress.

3. Build a network of people who can support you

This can include healthcare professionals, family, friends, and others living with atrial fibrillation either through in-person groups or online forums.

4. Work in partnership with your doctors

Your medical team’s job is to give you options about your treatment, so you can make decisions with them about your care, rather than you feeling as if your doctors are telling you what to do.

What to read next...