Understanding Atrial Fibrillation

January 18, 2024

What is atrial fibrillation?

What is AF? AF (or Afib) is a common type of irregular heart rhythm. AF is a medical abbreviation which means ‘atrial fibrillation’. This term refers to the atria (the two upper chambers of the heart which receive blood from your veins and push this blood into your ventricles). It also refers to fibrillation, meaning to quiver or contract spontaneously.

AF occurs when the atria experience chaotic electrical signals, causing them to ‘quiver’ rather than contract in a coordinated manner. This irregular and rapid electrical activity can disrupt the normal heart rhythm and lead to a variety of symptoms and potential health issues.

What are the symptoms of atrial fibrillation?

AF is associated with a range of symptoms, but not everyone with AF presents noticeable symptoms. Some people may have ‘silent’ AF, where the condition is detected during routine medical checkups – in other words, they do not experience the overt symptoms of atrial fibrillation. Other people may display typical symptoms simultaneously, such as heart palpitations and tiredness.

When symptoms of atrial fibrillation are present, they can vary in severity. The following are the most common symptoms of Afib:

1. Palpitations

The most common symptom of atrial fibrillation is heart palpitations. Atrial ‘flutter’ symptoms are a fluttering sensation or irregular, or rapid, beating of the heart. A heartbeat of more than 100 beats per minute is considered rapid – you can check your own heart rate by feeling your neck or wrist and counting the beats per minute.

Heart palpitations can last for a few seconds up until a few minutes. Some people describe this as a ‘quivering’ of the heart. Others may describe the sensation as twitching, fluttering, or spasming in the chest.

2. Fatigue

An AF heart condition can cause persistent tiredness or a lack of energy. This is due to the heart’s inefficient pumping of blood, which hinders the oxygen and nutrient rich blood which is distributed around the body. This can cause tiredness, sluggishness and fatigue.

3. Shortness of Breath

Some individuals with AF may feel breathless, especially during physical activity or exertion. This is because the heart works harder to meet the body’s demand for oxygen. An elevated heart rate can lead to an increased respiratory rate, making you feel like you’re out of breath.

4. Chest Pain or Discomfort

Chest pain, pressure, or discomfort may occur in people with AF, although it is less common than in other heart conditions like angina. If someone is experiencing anxiety or stress due to atrial fibrillation, this may manifest as chest discomfort or a feeling of tightness.

5. Dizziness or Lightheadedness

Afib can lead to a drop in blood pressure and reduced blood flow to the brain, resulting in dizziness or a feeling of lightheadedness. The severity of dizziness in AF can vary from person to person.

When should I be worried about an irregular heartbeat?

Everyone experiences a fluttering sensation in their hearts at some point during their lives; this ‘skipping a beat’ feeling can be brought on by a number of emotions, including excitement or nervousness.

However, you should go and see your doctor if you are experiencing frequent, rapid palpitations that last for a prolonged period of time. Remember, a rapid heartbeat is more than 100 beats per minute, and you can measure this at home by feeling your wrist or neck. You should also schedule an appointment if you experience chest pain or breathlessness. Your doctor can run some tests to see whether these palpitations are harmless or a sign of an underlying condition.

How is atrial fibrillation diagnosed?

If your doctor suspects you have atrial fibrillation, they will conduct a few tests to determine this. First, a pulse test is carried out, where your heartbeats will be measured within a time frame. A pulse of more than 100 beats per minute is an indication of atrial fibrillation.

The next step in diagnosis is an electrocardiogram (ECG), which measures the electrical activity of the heart and can detect an irregular pulse.

Finally, blood tests may be conducted to check for underlying conditions that could be causing or contributing to AF, such as thyroid problems or electrolyte imbalances.

Atrial fibrillation treatments

Treatment for atrial fibrillation depends on a person’s age, overall health, type of AF and underlying causes. The first step of treatment will be to determine any underlying causes for an AF heart condition. For example, if you have an overactive thyroid gland (hyperthyroidism), treating it may also cure atrial fibrillation.

If no underlying causes of atrial fibrillation can be found, treatment options can include the following:

1. Rate Control

The primary goal of rate control is to slow down the excessively fast and irregular heart rate associated with atrial fibrillation. A normal resting heart rate of fewer than 90 beats per minute can be achieved using drugs for atrial fibrillation. These include beta-blockers or calcium channel blockers.

2. Rhythm Control

Rhythm control aims to restore and maintain a normal heart rhythm. This can be achieved through various methods. The first is an electrical cardioversion, which delivers an electric shock to the heart to reset its rhythm to normal.

Catheter ablation can also control an irregular pulse. Ablation is a procedure which involves using catheters (thin tubes) to create scar tissue in the heart. This can help break up the electrical signals that cause rapid, irregular heartbeats.

Finally, antiarrhythmic medications are drugs which help maintain a normal heart rhythm and prevent AF recurrences.

3. Anticoagulation (Blood-Thinning) Therapy

Atrial fibrillation is associated with an increased risk factor for heart attack or stroke, due to the risk of blood clots in the atria. Typical drugs for atrial fibrillation are blood thinners, which may be prescribed to reduce the risk of stroke by preventing blood clot formation. The choice of blood thinner depends on individual risk factors and preferences.

4. Lifestyle Changes

Living with atrial fibrillation requires some lifestyle changes to help manage the condition. These include managing underlying health conditions, such as high blood pressure and diabetes; achieving and maintaining a healthy weight; and regular physical activity (which is possible and actively encouraged, bearing in mind some precautions).

5. Implantable Devices

Some individuals with an AF heart condition may benefit from implantable devices like pacemakers or implantable cardioverter-defibrillators (ICDs) to help control heart rhythm or manage complications.

My heartbeats are not constantly irregular – what does this mean?

If your irregular, rapid heartbeat seems to ‘come and go’, you may have what is known as paroxysmal atrial fibrillation (medically abbreviated as ‘paf’). In paf, abnormal heart rhythms occur intermittently and spontaneously but then return to normal rhythm on their own, usually within a few days. These episodes can last for a few seconds, minutes, hours, or even days, but usually cease on their own.

Paroxysmal atrial fibrillation can occur as a result of the same triggers as atrial fibrillation; namely poor diet, smoking, caffeine, alcohol and stress. As we have mentioned before, both forms of atrial fibrillation can also be caused by underlying health conditions, such as thyroid problems, that should be identified before starting any treatment.

What does af mean for my lifestyle?

When you first get diagnosed with Afib, it is important to take time to understand your condition and not to rush into any drastic life changes immediately. Make sure to read any resources given to you by your doctor, and go to your appointment with questions you have thought about in advance.

Once you have understood exactly what atrial fibrillation is, your doctor will speak to you about treatment options. However, outside of medical intervention through treatment, there are lifestyle changes that you should consider making that will help reduce your symptoms and the health implications of the condition.

Make sure to consult your doctor before making the following lifestyle changes:

1. Move towards a heart healthy diet

A heart-healthy diet can help control weight and blood pressure, which are important for managing AFib. Consider a diet rich in fruits, vegetables, whole grains, lean protein, and low in saturated fats, cholesterol, and sodium. Read our 15 Easy Food Swaps article for ideas.

2. Maintain a healthy weight

Being overweight or obese can increase the risk of atrial fibrillation and worsen its effects. Losing excess weight through a combination of diet and exercise can help.

3. Limit alcohol and caffeine

Excessive alcohol and caffeine consumption can trigger atrial fibrillation episodes in some people. Reducing or eliminating these substances from your diet may be beneficial.

4. Quit Smoking

Smoking is a significant risk factor for heart disease and can trigger and exacerbate AFib. Quitting smoking is one of the most important steps you can take for heart health.

5. Exercise

Regular physical activity can help improve overall cardiovascular health. Cardiac Lauren is the perfect programme for people suffering from AF. Lauren will explain the importance of a 15-minute warm-up and 10-minute cool-down to help prevent further irregular heart rates and participants find they are able to cope with a full exercise session when they incorporate these elements. Please note that if you are using smartwatches and heart rate monitors to monitor yourself during an exercise session, be aware that they are not great at picking up your heart rate. They often ‘guess’ the rate as the atria are contracting at different times. Watch this short video explaining more HERE.

6. Manage Stress

High stress levels can trigger atrial fibrillation or make it worse. Practices such as relaxation techniques, yoga, meditation, or deep breathing exercises can help manage stress.

7. Stay Hydrated

Dehydration can trigger AFib episodes, so it’s essential to stay well-hydrated, but avoid excessive fluid intake.

Living with atrial fibrillation also means attending regular appointments with your healthcare practitioner, to check in, discuss symptoms and ensure that you are on the most effective treatment plan. It may also involve taking daily medications as directed by your doctor.

How long can you live with an irregular heartbeat?

AFib itself does not necessarily reduce life expectancy on its own. However, AFib is often associated with an increased risk of certain complications, such as stroke, heart failure, and other cardiovascular problems. If AFib is well-managed and a person receives appropriate treatment and makes lifestyle changes to control risk factors, their life expectancy may not be significantly affected.

Again, it is important to note that following the treatment and recommendations from your doctor is extremely important; this will ensure a minimal impact on your life expectancy. Although atrial fibrillation has been linked to a reduced life expectancy due to risks of stroke and heart failure, many people with atrial fibrillation also live normal lives.

The importance of staying hydrated

December 14, 2023

The Body and Water

Did you know that your body is approximately 60% water? Different organs have a different water content, with your heart and brain being about 73% water and even your bones being 31% water!

However, your body loses water throughout the day through normal functions such as sweating and urination. The average person loses between 2.5-3 litres of water per day. If this water is not replaced, then your organs may not be able to work properly, which leads to symptoms such as thirst, brain fog and fatigue.

In fact, even being slightly dehydrated can impair your cognitive function. Persistent dehydration over the long term can also compromise your kidney health and also put pressure on your heart.

WHAT WATER DOES FOR YOU

The question here should perhaps be ‘What doesn’t water do for you?’ The following should make you realise just how crucial adequate hydration is for all aspects of your life.

1. Cognitive function

Dehydration can impair cognitive functions like concentration, memory, and mood. Staying hydrated can help you think clearly and stay alert.

Brain cognitive function and water cardiac lauren

2. Kidney function

Your kidneys rely on water to filter waste and excess substances from the blood, which are then excreted as urine. Adequate water intake supports kidney function and helps prevent kidney stones.

3. Cushioning joints

Proper hydration helps keep your joints supple and lubricated – reducing the risk of joint pain and stiffness.

4. Clean mouth

Drinking water helps to clean your mouth and reduces the likelihood of dental issues such as tooth decay.

5. Nutrient and waste transport

Water is the medium through which nutrients are transported to cells and waste products are removed from the body. Without enough water, these processes can become less efficient.

6. Temperature regulation

Water helps regulate your body temperature through processes like sweating. When you’re active or very hot, you lose water through sweat. Adequate hydration helps keep your body cool. In the Cardiac Lauren classes, you are encouraged to drink throughout the session to remain as hydrated as you can be.

7. Digestion

Water is necessary for digestion and the absorption of nutrients. It helps break down food in the stomach and moves it through the digestive tract.

Hydration, digestion and gut health cardiac lauren

8. Skin health

Proper hydration can improve skin elasticity and health. Dehydrated skin can appear dry, flaky or wrinkled.

9. Weight management

Drinking water, especially before meals, can help control your appetite and reduce calorie intake. This can potentially aid in weight management efforts.

10. Detoxification

Water plays a role in flushing toxins and waste products out of your body through urine, sweat, and bowel movements.

Hydrated? How much should I drink?

The amount of water a person should drink can vary depending on various factors, including individual needs, activity levels, climate, and overall health. A good rule of thumb is to aim for 2 litres of water per day (more if you exercise and lose water through sweat).

Remember in the UK tap water is safe to drink. Read about the water cycle with Thames Water here.

Can I get water through other drinks?

Although you should avoid solely relying on other beverages to count towards your water intake, some drinks do contribute to keeping you hydrated.

Tea (particularly herbal teas) and coffee are largely made from water and, therefore have a hydrating effect. However, drinks that contain a lot of caffeine (for example, coffee) can lead to fluid loss as they are diuretics; this means that they can increase urine production, potentially leading to dehydration.

Any drink with a high sugar content should also be avoided or consumed only as an occasional treat, as sugar has a dehydrating effect. This includes fizzy drinks, fruit juices, smoothies, squash and (especially) alcohol. Diet drinks should also only be enjoyed in moderation; drinks with artificial sweeteners as such should not be used as a substitute for drinking water.

TIPS FOR INCREASING WATER INTAKE

Ensuring that you get enough water each day can take time and is often a process of building healthy habits. There are lots of small steps you can take to increasing water intake in your daily life; you can start small and gradually build up the following tips:

1. Set a goal

Set yourself a realistic and measurable goal to increase your water intake; for example, to drink a cup of water before your morning coffee, to drink water with every meal or to drink four 500ml (reusable) bottles of water each day.

2. Start each day with a cup of water

Starting the day by simply drinking a cup of water will rehydrate your body after sleep. It also sets the precedent for drinking water the rest of the day and is an easy habit to make stick.

Hydration morning glass of water cardiac lauren

3. Eat more water-rich foods

Many fruits and vegetables have high water content, such as watermelon, cucumber, and lettuce. Incorporate them into your diet to increase your water intake.

4. Watch out for sugar, alcohol and salty foods

Sugar can have a dehydrating effect, as will salty foods and alcohol especially. Make sure to minimise your consumption of all of these groups or – if having the occasional indulgence – make sure to drink plenty of water.

5. Look at your urine

Yes, you read that right! Keep an eye on the colour of your urine to assess your hydration levels throughout the day. It should be a pale yellow colour – the darker it is, the more dehydrated you are. Click here for the NHS urine colour chat to check yours.

6. Invest in a reusable bottle

By investing in a reusable bottle, you’ll not only be helping to protect the planet, but you’ll also be more likely to get the most out of your money and drink more water! Your new bottle will be a visual reminder for you to drink more throughout the day.

Hydration reusable water bottle cardiac lauren

7. Pay attention to your body’s signals

Try to listen to your body’s signals throughout the day, particularly when you are thirsty. Bear in mind that some people often feel ‘peckish’ when the body is slightly dehydrated. Rather than reaching for a snack, they should be drinking a glass of water.

Can I drink too much water?

Drinking an excessive amount of water can dilute the amount of sodium in your bloodstream, which is crucial for various functions in the body. In this way, yes, it is possible to drink too much water – but this is extremely rare.

Never force yourself to drink excessive amounts of water. Instead, listen to your body and aim for 2 litres of water on average per day.

What are the 4 phases of cardiac rehabilitation?

August 24, 2023

What is Phase 1 of cardiac rehabilitation?

Phase 1 refers to the acute stage of the heart condition, and often, it starts from a person’s diagnosis following the heart event. Most cardiac rehabilitation patients will have been admitted to the hospital during Phase 1 – after having had the heart event (myocardial infarction) which may have been called acute coronary syndrome on the discharge notes. During Phase 1, the main goals of recovery are as follows:

To stabilise the patient so that the symptoms do not worsen

To prevent further damage to the heart

To initiate treatments to help the heart muscle recover

The length of Phase 1 rehabilitation depends on the nature of the condition and the extent to which the heart has been damaged. Each person is different, and while one person may respond to initial treatments immediately, others may take longer. It is therefore important to try and be patient while in Phase 1; the lack of control can be frustrating, but the most important thing is that you don’t rush the process.

Male holding heart - mild heart attackthe 4 phases of cardiac rehabilitation

What is Phase 2 of cardiac rehabilitation?

Phase 2 occurs after Phase 1, outside of the hospital setting. It is when patients who have suffered a heart event are discharged from the hospital, return to the care of their GP (General Practitioner) and are thereby classified as ‘outpatients’. However, people who have had surgery, CABG and valve repair or replacements in particular, will have the district or cardiac specialist nurse attend their homes or have appointments with them, so that any lacerations resulting from surgery can be looked after. If you had stents fitted then you will have been given verbal and written information about the early days of your recovery when at home.

For most Phase 2 patients, discharge summary notes from the hospital will have been forwarded to the local NHS cardiac rehabilitation team and they will make contact by phone. At this initial contact, the patient will be able to ask questions and get advice about taking pain relief, what joint mobilisation and muscle stretches to do, and how to cope with things like coughing or sneezing after having a sternotomy (surgical procedure).

Phase 2 lasts for two to six weeks depending on the heart event or diagnosis. Everyone at this stage will be encouraged to keep moving around the home and start a gradual walking programme. The aim is to achieve 30 minutes of continuous walking daily by the end of the six weeks. For some people, this is easily achievable, whereas others will need longer and their goal may be to just do 10 minutes of activity each day. The cardiac rehab team sees everyone as an individual and will tailor their recovery to each person.

What is Phase 3 of cardiac rehabilitation?

Phase 3 is where you will start a comprehensive cardiac rehabilitation programme, predominantly with your local NHS team. This is different from Phase 2, where you are still recovering, understanding and adapting to your diagnosis.

In Phase 3, education, exercise and support from a multidisciplinary team are put together in a 4–12-week programme. The primary goal of Phase 3 cardiac rehabilitation is to help individuals return to their normal daily activities and improve their overall health and well-being.

Participants may attend organised sessions in their local hospital, medical centre, a local gym, or community hall to receive Phase 3 care. Some attend once a week, others twice, or more. Many people are now offered hybrid programmes of a mix of online and face-to-face classes, as well as phone apps and computer websites to guide them through the whole cardiac rehabilitation process.

Food heart - cardiac lauren food swaps — Diet advice

Level 3 - workout a - phase 3 cardiac rehabilitation exercise video — Diet advice

The main aims of Phase III are to:

Educate you about your condition – why it happened and how to prevent it from happening again.

Educate and support you on any changes you need to make to your lifestyle – such as diet, stopping smoking, losing weight, exercising more, lowering stress levels, managing blood sugar levels (if you are diabetic) and reducing alcohol intake.

Support your mental well-being and manage anxiety and stress.

Encourage you to be more active in everyday life.

Be able to achieve 20 minutes of continuous cardiovascular exercise.

Be able to monitor yourself whilst exercising so it remains at a safe intensity level.

Understand what and why you take the medication you have been given.

Learn to live with your condition and for it to not be a reason to stop doing many of the things you did before or would like to do in the future.

In terms of exercise, some Phase 3 cardiac rehab programmes are based in a gym or have gym equipment (bikes, treadmills, rowing machines, steppers etc), whilst others will have a circuit format using weights, resistance bands, steps and your own body weight. No method is better than the other, especially as the main aim is to achieve 20 minutes of continuous aerobic exercise, and each participant will be exercising at a different intensity to the other.

At the end of the Phase 3 programme, everyone will have a better understanding of their condition and how to live with it. For most people, apart from having to take medication daily, their lives can continue as before with the new lifestyle changes they have put in place. For some, their condition requires regular monitoring, but this does not mean they cannot continue to progress on their cardiac rehabilitation journey. If anyone is waiting for a medical procedure, being as fit and healthy as possible pre-operation is extremely beneficial and will make recovery a quicker experience.

What is Phase 4 of cardiac rehabilitation?

Phase 4 of cardiac rehabilitation is where the fun starts! Phase 4 is a chance for you to invest in your long-term mental and physical health, in a safe manner considering your history of a heart event.

The Cardiac Lauren philosophy is that Phase 4 improves not just your overall fitness, but your quality of life. Each online class guides people with a history of a heart event through exercises where no gym membership or expensive equipment is needed. In fact, the most you will need is a chair and milk cartons if you don’t own any lightweights!

There is a diverse range of classes to choose from at Cardiac Lauren, to suit your confidence, ability and mood. You can sample seated classes, high-intensity classes, post-walk classes and many, many more.

All intensity levels - cv, sides & extras

Seated - a normal class, just seated instead

Although some patients may feel anxious about the strain they may be putting on their heart in exercise classes, especially as they challenge themselves to harder exercise, however, Cardiac Lauren’s classes make use of RPE, which stands for Rating of Perceived Exertion (you are likely to have used this in Phase 3).

RPE is a subjective measure of how hard someone feels they are exercising – to help people gauge their intensity level during physical activity. Anywhere between RPE 11 & 14 is generally desired – i.e. ‘fairly light’ to ‘somewhat hard’.

Cardiovascular exercise strengthens the heart muscles, enabling you to feel fitter and stronger in daily life.

Phase 4 should be a fun, accessible and sustainable addition to your life, which enables you to live your life without the frustration and restrictions of your heart event history. It also decreases your likelihood of having another heart event, as your heart adapts to exercise and becomes stronger.

Cardiac Rehabilitation