The wildly beating heart, fatigue and other debilitating symptoms are well known to the many millions of people impacted by atrial fibrillation. Some of those who have afib may have no outward symptoms, but are still at risk of serious and long-term damage to the heart.
Symptoms or not, rate control is the common treatment of choice, especially from those healthcare providers who are not well versed in afib treatment options. But this treatment sort of suspends afib patients in a “waiting and watching” middle ground, stuck in limbo with a diminished quality of life and an increased risk of stroke.
Yet, the doctors prescribing rate control for afib are just following the guidelines. Rate control medications (typically beta blockers) work by slowing down the heartbeat, but often leave patients in afib. So while rate control may not put patients at risk today, they may suffer the effects years later. What’s worse, though, is that the underlying problem of afib isn’t addressed.
Emerging research shows that allowing patients to stay on rate control could have some long-term, serious consequences. The irregular heartbeats can cause remodeling and fibrosis of the heart, and new research has correlated this afib-related fibrosis with stroke. Even on rate control medications, afib patients may have an elevated risk of stroke because rate control allows the haywire circuitry of the heart to continue causing damage. In addition, a recent study published in the Journal of the American College of Cardiology found that rate control treatment didn’t seem to improve quality of life for afib patients.
Patients often don’t realize why they are taking rate control medication and may not understand that the drugs won’t stop the afib. Some patients may not be able to comprehend the seriousness of their condition because of the brain fog and short-term memory loss that many patients experience on rate control medications. While doctors usually see these medications as benign, patients often experience an energy-sapping, zombie-like feeling while on the drugs. Rate control drugs can decrease the quality of life as much as afib itself.
Elderly patients may have it even worse because the rate control medications often make these patients feel so tired that they can’t walk up stairs or play with grandchildren. Because of this constant fatigue, they may give up exercising and become inactive, allowing their health and quality of life to continually diminish.
And for patients who are paroxysmal, going in and out of afib frequently, rate control just may leave the heart rate too slow when they are not in afib, making them feel miserable.
So, it’s time for new thinking about afib treatments. We need to go beyond the current recommended guidelines. Medicine has discovered better afib treatment alternatives, including catheter and surgical ablation procedures that can restore patients to normal sinus rhythm and prevent debilitating strokes.
By 2050, up to 16 million people in the US alone will have afib. We can’t afford the cost and human toll of continuing to watch and wait.
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