ATRIAL LIVING WITH FIBRILLATION (AF): DO WHAT YOU CAN LEARN WHAT YOU CAN. An informative booklet for individuals with AF and those who care for them.

Transcription

1 LIVING WITH ATRIAL FIBRILLATION (AF): LEARN WHAT YOU CAN DO WHAT YOU CAN An informative booklet for individuals with AF and those who care for them. INTERNATIONAL

2 About This Booklet Atrial fibrillation (AF) is a common heart condition affecting adults around the world. It is important to know about AF, because it can lead to hospitalizations and serious events, such as stroke. This brochure can help you learn more about what happens in the heart when you have AF, what causes it, and the types of treatment used to manage AF. 1,2 Whether you have AF or you care for someone with AF, it s important to: Learn what you can. And, Do what you can. AF AWARE (Atrial Fibrillation AWareness And Risk Education) is an international awareness campaign, dedicated to gaining greater recognition of atrial fibrillation (AF) and its impact as a major international public health concern. AF AWARE is a collaboration between the World Heart Federation, the Stroke Alliance for Europe (SAFE) and the Atrial Fibrillation Association (AFA) all three organizations are founding partners and active participants of the campaign. The activities of the AF AWARE campaign are supported by funding from both Sanofi and Boehringer Ingelheim. The AF Aware campaign is concluded and the three partner organizations are distributing materials through their own channels. The World Heart Federation s AF-related activities operate under the Global AF Action (GAFA) programme as part of the 25x25 campaign. In This Booklet Learning About AF What is AF? 4 What happens in the heart when you have AF? 4 What are the types of AF? 5 How common is AF? 6 What are the symptoms of AF? 8 Why should I be concerned about AF? 9 What are the health factors that can lead to AF? 10 Managing and Treating AF Nonsurgical procedures 11 Medications 12 Talking to Your Doctor About AF

3 Learning About AF What is AF? 1,3 AF is an irregular heart rhythm that is often described as having a feeling of heart palpitations or a flip-flopping or fluttering of the heart in the chest. It scared me because it had to do directly with my heart. What happens in the heart when you have AF? 4,5 Male, 68, France The heart is divided into 4 sections, called chambers. Each one is labeled in the diagram below. Without any warning, a piece of the clot can break off and travel into normal blood circulation. But clots are too big for some parts of the body s blood circulation. They can block a small blood vessel and stop blood from reaching an area that needs it. If this happens in the brain, a stroke can occur. What are the types of AF? 1,2 AF is grouped by how long the episode lasts. There is no way to tell how much you will feel the fibrillation or fluttering (see page 8 for What are the symptoms of AF? ). Infrequent AF Short episodes of AF that come and go are called paroxysmal. These episodes stop by themselves, usually within 48 hours, but may continue for up to 7 days before the heart goes back to its normal speed. Right atrium Left atrium Left ventricle Long-term AF Persistent AF is when the episodes last longer than 7 days. Eventually, infrequent episodes turn into long-term episodes of irregular beats. In other words, AF eventually becomes persistent. The chambers work together to pump blood. The top chambers pull blood into the heart, and the bottom chambers push the blood out to the rest of the body. When you have an episode, the top chambers start to fibrillate (contract very quickly and irregularly). This prevents the upper and bottom chambers from working together the way they should, so some blood doesn t get pumped to the left ventricle. How AF can lead to risk of stroke 3 Right ventricle Blood that doesn t get pumped to the left ventricle builds up in the left atria (and in a little pocket called the left atrial appendage). When blood sits in this pocket, it can begin to clot. Permanent AF Over time, long-term AF becomes permanent. Most people with AF have permanent AF. Silent AF Again, the type of AF depends on how long the episode lasts. But, while in fibrillation, 1 out of 3 people with AF have no symptoms. This is called silent AF. Often, the AF is not discovered until after there has been a complication from AF, like a stroke or heart failure. But, it can be diagnosed (with some lucky timing). 1,2,6 4 5

4 How common is AF? 2,7 AF is the most common abnormal heart rhythm in the world. There are an estimated 9 million people who currently have AF in Europe and the US. This number could double to 18 million in the next 50 years as people age. Over 9 million people in the world with AF Every 12 seconds 1 person has a stroke related to AF 8 10 US 3 million EU 6 million Did you know If you have AF, you are 4 to 5 times more likely to have a stroke? 8 AF can increase chance for hospitalization 1 out of 3 cardiac admissions is due to AF 2 6 7

5 What are the symptoms of AF? 1,2 The symptoms of AF can be different from person to person. Some people may not experience any symptoms at all. Symptoms may include: Heart palpitations When your heart begins racing or beating in an irregular way, it may feel like a sudden pounding, fluttering, or racing feeling in the chest. Dizziness Dizziness can happen suddenly, and you may feel light-headed or like you could faint. Shortness of breath You may find it difficult to breathe while you are doing normal activities, or even when you are just sitting down or resting. Weakness You may have a feeling of being overtired or lack the energy to do the things you would normally do. Chest discomfort You may feel pain or pressure in your chest. Remember, sometimes you may not experience any symptoms of AF at all. This does not mean you do not have AF or your AF has gone away. AF is very serious and you should always follow your doctor s advice. 1,2 Did you know Symptoms of AF often become worse with time, which can severely affect your ability to do simple daily tasks. This can lead to depression. 11 Why should I be concerned about AF? AF can affect you in many ways, both in your day-to-day life and in your overall health. 12 Stroke 1,2,8 Of course, the biggest concern you and your doctor will have about AF is the risk of stroke. (If you have AF, you are 4 to 5 times more likely to have a stroke. And, AF doubles the risk of death.) Heart events 1,2 AF can lead to other heart problems, including: Heart attack A heart attack is also called a myocardial infarction, or MI for short. Heart failure Heart failure occurs when the heart simply cannot pump enough blood to meet the body s needs. Hospitalization 13 Having AF can increase the chance that you will face hospitalization. Although there are other conditions that can cause heart fibrillations, AF is the most common one that results in admission to the hospital for a heart event. In one year, 3 out of 10 people will have to go into the hospital because of a heart event that results from having AF. Quality of life 1,2 With AF, fibrillations and other symptoms will likely have an effect on your day-to-day life. Some days may be better than others, but you may find you need to reduce or modify day-to-day activities. Or you may just not feel well lacking energy, feeling overtired, short of breath, or light-headed. 8 9

6 What are the health factors that can lead to AF? Some people can get AF without having anything else. This is known as lone AF. 14 But most people have other health conditions that can increase their risk for developing AF, such as: Age 9 There is a greater chance of having AF the older you get. In people aged years, around 1 out of 200 has AF. In people aged 80 years and older, this rises to around 1 in 10 who have AF. High blood pressure 1,15 High blood pressure is the most common health factor that can lead to AF. Diabetes 16 People who do not have well-controlled blood sugar levels are at risk for developing AF. History of heart disease 3 For example: If you were born with heart problems Heart failure Heart damage from other illnesses Managing and Treating AF Nonsurgical procedures 1 There are some nonsurgical treatment options that your doctor may recommend for you, based on how severe or frequent your symptoms are and whether you already have heart disease. Electrical cardioversion During this procedure, low-energy shocks are given to your heart to try to return the normal rhythm of your heart. Radiofrequency or catheter ablation This procedure (you can call it by either name) may be used to restore a normal heart rhythm when medicines or electrical cardioversion don t work. If they have a diagnosis, they can treat it. I know how to control and attack and get control of this monster. Female, 75, Spain Did you know Once you have AF, these health factors increase your risk for stroke 1,2 : Age Some types of heart disease High blood pressure Diabetes 10 11

7 Medications 1,2 Most people with AF are managed with medications. Your doctor will decide which medication is right for you. Antiplatelet medications Antiplatelet medications are used in people to help prevent stroke. In AF, they are sometimes used for people with a low risk of stroke. Antiplatelets are sometimes referred to as blood thinners, although technically they don t thin the blood. Anticoagulants Anticoagulant medications help to prevent clots from forming. Because they work to prevent clots, they are also sometimes called blood thinners. But most important, anticoagulants are the best medications to reduce your risk of stroke. Most people with AF are given anticoagulants to help protect them from the risk of stroke. Please be aware that regular blood tests may be required when taking certain treatments in order to measure the effectiveness of the drug and to determine if the dose needs to be adjusted. Rate controllers Rate control medications help to slow the heart rate (number of beats per minute) to a normal level. These medicines are usually recommended for people with AF who are not physically active. Rhythm controllers (antiarrhythmic agents) Rhythm controllers help return and maintain the heart s normal rhythm. Rhythm control medications are recommended for people who have only recently started having AF. Always take your medicine It is important that you take all doses of your medication especially when consequences as serious as stroke are involved. If you miss a dose, be sure to read the medication dosing guide or speak to your physician to understand when to take the next dose. Of course, the best thing is not to miss a dose! Tips for taking your medicine the right way: Keep an updated list of the medicines your doctor has prescribed for you Take each medication as prescribed Take your medicine on time Keep a calendar to remind yourself of when to take it Do not increase or decrease the dose Inform your doctor immediately if you stop taking it for any reason Tell your loved ones about the medicine you are taking so they can remind you to take it Do not skip a dose 12 13

8 Talking to Your Doctor About AF Notes You have learned a lot about AF. Now, do what you can about AF. Do Go to your doctor whenever you feel a difference in your symptoms or in your response to your medications. Remember, AF is a serious disease that can have serious outcomes. If an adjustment needs to be made in your care, both you and your doctor will be glad you made an appointment. Do Tell your doctor everything at every visit so that he or she can better evaluate a medication or treatment option for you: Any symptoms you ve had and when you ve had them Any side effects to medications All medications you re taking, including over-the-counter herbal supplements and vitamins Anything out of the ordinary that you ve done perhaps a place you ve visited Do Ask questions when you next visit your doctor, and get answers that can help you understand your AF care better. Here are some questions you can ask your doctor about your AF: References: 1. Fuster V et al. J Am Coll Cardiol 2011; 57:e101 e Camm J et al. Eur Heart J 2010; 31: National Heart Lung and Blood Institute. What is atrial fibrillation? Accessed May 23, Heart Disease. Mayoclinic.com reprints. METHOD=print&DSECTION=all. Accessed June 7, Mayo Clinic medical information and tools for healthy living - MayoClinic.com. Chambers and valves of the heart. mayoclinic.com/health/medical/im Accessed May 24, Savelieva I et al. J Interv Card Electrophysiol 2000; 4: Naccarelli GV et al. Am J Cardiol 2009; 104: Wolf PA et al. Stroke 1991; 22: Lin HJ et al. Stroke 1996; 27: Atlas of Heart Disease and Stroke, World Health Organization, September Viewed July 2009 at Thrall G et al. Chest 2007; 132: Dorian P et al. J am Coll Cardiol 2000; 36: Savelieva I et al. Clin Cardiol 2008; 31: Kopecky SL et al. N Engl J Med 1987; 317: Le Heuzey J et al. Am Heart J 2004; 147: Dublin S et al. J Gen Intern Med 2010; 25: How serious is my AF? 2. Do I need to make any changes in my lifestyle? 3. What are my treatment options? 4. Is medication an option for me? 5. What are my treatment goals? 14 15

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