Taking it to Heart

When the Beat Goes Wrong: Age, obesity can lead to increasingly prevalent, serious heart disorder

By Debra Melani

For some people, it feels like Ringo Star belting out a drum solo right in the middle of their chest. For others, it's more like the catch of the day from a fishing trip flopping around beneath their breast bone. And still others simply describe it as a racing heart—one that's threatening to make a grand escape.

However they illustrate their atrial fibrillation, most of the 2.5 million U.S. sufferers will report it's no fun. Tim Vermeer (pictured right), who uses the fish scenario when describing his atrial fibrillation (A-Fib), says he first noticed his heart disorder 13 years ago when playing 10 minutes of his favorite sport of basketball suddenly felt like running a marathon.

Tim Vermeer, Atrial Fibrillation Patient"I was just wiped out," says Vermeer, a 46-year-old husband and father of three, who added that his heart seemed to pound harder and faster longer than usual after exercise. Only 32 then and conditioned on the basketball court, the change spurred a trip to the doctor. After a rushed transfer to the emergency room, he was diagnosed with A-Fib, a common arrhythmia, which is alarmingly on the rise.

A Common Heart Problem: Atrial Fibrillation

"Yes, indeed, it is the most common problem we see for whatever reason, whether it's being better recognized, which is part of it, or whether it's the impact of obesity, diabetes and hypertension," says Dr. Charles Fuenzalida, a cardiac electrophysiologist with The Medical Center of Aurora. But the bottom line is, those who have it should take it seriously and see their doctors. A-Fib can increase your risk of heart failure and boost chances of having a stroke five-fold.

With A-Fib, the heart's electrical system stops functioning correctly and fails to stimulate full contractions of the upper two chambers of the heart (the atria, which fibrillate, sometimes at 300-600 beats per minute), says Dr. Cinthia Bateman, a cardiologist with Swedish Medical Center. "And you have pockets that are called appendages in the top chamber where blood can then stagnate," Dr. Bateman says. "The stagnated blood can form clots and be released, causing a stroke (when oxygen is deprived to the brain)."

Treating A-Fib

Medications to control the fibrillations are generally doctors' first line of defense. "But everyone is different," says Dr. Fuenzalida. "It's not a cookie-cutter approach to treatment." In Vermeer's case, he started with medications with his regular doctor, but when he was dissatisfied, found Dr. Fuenzalida, who specializes in these types of heart malfunctions. "He's the guy. He told me things about my heart and what it was doing that nobody ever could tell me before."

Vermeer knew Dr. Fuenzalida was skilled at a relatively new technique called atrial ablation. He asked the doctor to perform the procedure right away. "But he said, as long as your medications are working, we're not going to do that." Vermeer waited relatively patiently.

Finally, when the fibrillations were breaking through the medication, which was happening about four times a month, Dr. Fuenzalida performed the surgery. The procedure requires general anesthesia and involves ablating, or burning, the areas of the heart responsible for the erratic impulses. Vermeer sees it more as a permanent fix, although there's a chance that he might need surgery or medications again if the heart forms more trouble areas.

Life Following Surgery

But for now, Vermeer feels great, taking only an aspirin regimen rather than heavier duty blood thinners to help prevent stroke and no other medications. Knowing that obesity (which affects 30 percent of the U.S. population) and poor habits such as smoking, drinking and stress can trigger atrial fibrillations (which can be short-lived when the triggers are alleviated but can lead to bigger troubles in the future), Vermeer focuses on a healthy lifestyle.

"I never smoked or was much of a drinker. But now I focus more on a healthy diet, and I manage my stress. I play basketball and walk three times a week. I've cut 10 pounds since the surgery, and I have no restrictions —other than I'm 46. I feel great."

Keeping Atrial Fibrillation at Bay

Dr. Bateman would say Vermeer has the right idea. Baby boomers might not be able to ward off atrial fibrillation, which most often results from aging, but they can keep it at bay for as long as possible. "I think that at the end of the day, we really have to focus on a better lifestyle. We have to eat healthy. We have to exercise. We have to take care of ourselves. And women, in particular, need to know heart disease affects them. They need to be aware of their symptoms and realize they are not necessarily made up."


Signs & Symptoms

  • Sudden flutter of heart
  • Shortness of breath
  • Anxiety
  • Weakness
  • Difficulty exercising
  • Chest pain
  • Sweating
  • Dizziness
  • Fainting

Source: Heart Rhythm Society


Treatments

  • Medications
  • Controlled electric shocks to heart
  • Ablation to destroy tissue giving rise to irregular rhythm
  • Pacemaker

Source: Heart Rhythm Society


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