During AFib, abnormal electrical signals in the heart may cause irregular heartbeats, or electrical impulses may circulate through the heart erroneously causing irregular contractions of the atria. Your heart may beat too slowly, too quickly or in an uneven rhythm. Recognizing risk factors such as age and family history, personal or environmental triggers and avoiding them whenever possible may help you manage atrial fibrillation effectively. Though there is no “one cause” of AFib, there are some factors that can be managed through lifestyle or medication. In at least 10% of cases of afib, no underlying heart disease is found but incidents of AF may be related to metabolic or electrolyte imbalances, severe infections, genetic factors or even caffeine use or stress. In some cases, no cause can be found.
What causes afib?
Some of the more common causes of atrial fibrillation include chronic lung disease, heart failure, heart valve disease, hypertension (high blood pressure), congenital heart disease, cardiomyopathy, coronary artery disease and pulmonary embolism. Some less common causes can include hyperthyroidism, pericarditis or viral infections. There are significant findings that environmental and personal choices such as stress levels due to moving, work and family could be leading causes of AFib and related concerns.
There are a number of risk factors that may lead to atrial fibrillation in individuals. As we age, many cardiac conditions are more likely to manifest themselves, and AFib is more likely to occur after the age of 60. If someone in your close family has had the condition, you are also more likely to develop afib at some point as well. The risk factors for atrial fibrillation are as numerous as the symptoms, but one of the most important risk factors is existing heart disease such as inflamed heart muscle or lining, previous heart attacks or congestive heart failure or recent heart surgery. The condition is also relatively common following coronary artery bypass (CABG) and following valve surgery, with occurrence in up to 40% of patients following a coronary bypass event.
Angina (chest pain) and clogged arteries, especially in those individuals who have or are prone to episodes of high blood pressure, thyroid problems or diabetes have been found to increase risk. Chronic lung disease, asthma, emphysema and even pulmonary blood clots can also point towards an increased risk for atrial fibrillation.
Women are more likely than men to die prematurely from the condition, but men are much more likely to develop it. Age can be a risk factor as AF is more likely to start as individuals move into their early fifties, and can often start in an individual’s thirties or forties. It’s even becoming more common in young people in their teens and early twenties, possibly brought on by risk factors such as obesity, excess caffeine or alcohol, smoking or over-exercising.
Sleep apnea and obesity have been at the forefront of some recent research, although underweight and normal-weight people also suffer from the condition. One study cites an individual who underwent gastric-bypass surgery which briefly relieved her afib condition, but it was renewed by a simple sinus infection. Obstructive sleep apnea does appear to be a major risk factor, as about half of afib patients have this condition, and it’s on the forefront of recent research. This could be tied to the fact that obstructive sleep apnea is most prevalent in overweight males–the same demographic that is at the highest risk for afib and other cardiovascular diseases. Patients with untreated sleep apnea were more likely to revert back into afib after electrical cardio version than other afib patients without sleep apnea.
Sleep apnea, as well as afib causes, are correlated with high levels of a marker of inflammation that indicates the possible presence of heart disease, indicating a cross-correlation between sleep apnea, afib and obesity.
Other risk factors include recreational drugs, exposure to chemicals and pesticides, ulcers, and the presence of excess minerals within your body such as calcium, magnesium or potassium.
Most commonly, atrial fibrillation occurs as a result of some other cardiac condition (secondary atrial fibrillation). Some of the other likely cardiac conditions include: heart valve disease caused by infection or degeneration of valves with age; high blood pressure or hypertension; sick sinus syndrome, or improper production of electrical impulses in the atrium of the heart; myocarditis/pericarditis, inflammation of the sac surrounding the heart or the heart muscle itself; coronary heart disease or coronary artery disease resulting from atherosclerosis, narrowing of the arteries, fatty blockages, or interruptions of the oxygen delivery to the heart; enlargement of the left ventricle walls, also referred to as ventricular hypertrophy.
Other cardiac conditions such as rheumatic heart disease and heart birth defects can increase the likelihood of afib occurrence as well. Congenital heart disease, problems with the heart’s structure that are present at birth, could include defects to the heart’s blood vessels that carry blood to and from the heart, interior walls or valves. Defects such as this could alter the normal flow of blood through the heart triggering an episode of afib. The abnormal leaking of blood through the mitral valve, known as mitral valve disease, is another potential cause.
Atrial fibrillation may occur without any evidence of underlying heart disease. This is more common in younger people, half of whom do not have any other heart problems. This is often called lone atrial fibrillation. Some of the causes that do not involve the heart include: alcohol use or suddenly-discontinued medications, often called “holiday heart” or “Saturday night heart” since conditions often subside once the behavior is reviewed and resolved; pulmonary embolism and pneumonia as well as an overactive thyroid can contribute to afib conditions as well.
Recent research suggests that people, who take high doses of steroids, perhaps for asthma or other conditions that cause inflammation, may be at greater risk for afib. If your chances are higher anyway, this treatment can trigger an episode.
Stress seems to be a common denominator in the trigger of afib episodes. When individuals suffering from this condition were asked, stress at work was often a factor, along with moving and high blood pressure–which is likely related to the stress. Chocolate and caffeine were also mentioned as potential triggers, which isn’t surprising since individuals tend to ingest chocolate and caffeine when feeling stressed. Exercise has also been mentioned as a trigger; but stress, excessive travel, family pressure and work pressure can bring on symptoms between a heavy anxiety attack and a heart attack related to atrial fibrillation.
Some individuals report that afib feels akin to a heart attack, with your heart skipping a beat, a strong feeling of dizziness, blurry vision and coldness or numbness. Changes in air pressure during a flight have also been known to bring on a sudden attack of afib. Triggers are actually a controversial topic within the afib community, as some doctors believe that trigger tracking can cause you to cut out “triggers” which actually didn’t impact your afib activity at all, and may actually be beneficial.
Additional behavioral triggers include smoking, excessive caffeine consumption including energy drinks, coffee or tea; alcohol abuse, defined as excessive, regular and long-term consumption of alcohol. Some studies show that atrial fibrillation is as much as 45% higher among those who regularly overindulge in alcohol consumption, which is a pretty strong correlation.
Physical illness, fatigue, and recent surgery are also common triggers. When combined with stress and lack of sleep, the lack of regular electrical activity in your heart accelerates, making good sleeping and eating habits crucial especially for individuals with high-stress jobs or those who travel regularly.
Surprisingly, over the counter medications such as cold or allergy medicines may trigger an episode. Dietary supplements and nasal sprays are specifically known to contain ingredients which may cause unexpected afib. Hormone supplements and the normal fluctuation of hormones in women can cause irregular heartbeats, especially in women who are premenopausal or those with diagnosed menstruation problems.
Did you know that the pollen levels can affect your heart? Checking local air quality and wearing a mask when pollen and pollution levels from cars and power plants are high can help prevent atrial fibrillation. Don’t go outdoors when pollution levels are too high.
Finally, dehydration or any significant change in fluid levels can affect any number of bodily functions, including that of the heart. Changes in eating patterns, exhaustion, physical exertion, and dehydration are leading non-cardiac risk factors or triggers to be on the lookout for. Watching your salt intake can also help you avoid dehydration. Dehydration can also cause dangerously low blood electrolytes such as potassium, which can trigger abnormal heart rhythm. This is most common in hot weather, especially when exercising outdoors, but it can also result from an illness that includes vomiting or diarrhea. Be sure to drink plenty of water on hot days and whenever you’re sick.
Paying attention to your body, and knowing some of these triggers and what to do when they happen can help minimize the potential of having an atrial fibrillation prognosis.