CardioSmart | Atrial Fibrillation
Atrial Fibrillation and High Blood Pressure
Q: My husband is 30 years old and has been in the intensive care unit four times for complications related to atrial fibrillation. His heart has two rhythms — one that is too fast, and one that is too slow. He also has high blood pressure and sleep apnea and is overweight. He’s already taking medication, but is there anything else we can do to improve his health?
A:As doctors, one of the most rewarding aspects of caring for patients with atrial fibrillation is that in order to do a good job we have to look at the whole patient. So I applaud the approach you are taking to improve your husband’s overall health. With all of our patients with atrial fibrillation, we need to make sure that atrial fibrillation is not the first sign of other (more worrisome) heart conditions. That is usually accomplished with a complete medical evaluation and an echocardiogram. Once that is done, we focus on managing three aspects of atrial fibrillation:
- Is the heart rate or rhythm problematic in and of itself? Does the atrial fibrillation cause bothersome symptoms, or is the heart rate too fast or slow?
- What is the stroke risk associated with atrial fibrillation? Is anticoagulation medicine recommended for stroke prevention? Medicines can usually be used to address stroke risk, as well as atrial fibrillation symptoms.
- Lastly, and perhaps most importantly, we address other health conditions that may increase the risk of atrial fibrillation related complications.
In your husband’s case, it sounds like obesity may be contributing to his risk of sleep apnea and hypertension (high blood pressure), both of which increase the risk of arrhythmia. I think adding diet and exercise to the medical regimen suggested by his doctor would improve his overall health dramatically.
Philip Green, MD, Assistant in Clinical Medicine, Division of Cardiology, Department of Medicine at Columbia University Medical Center in New York.
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