Atrial fibrillation (afib) is a common heart rhythm disorder in which the upper chambers of the heart (the atria) beat fast and irregularly. Afib commonly causes recurrent symptoms, usually palpitations and shortness of breath, and can negatively affect quality of life. Afib also substantially increases the risk of stroke, and is also associated with heart failure, high blood pressure, and diabetes. People with afib routinely require lifelong treatment with blood thinners, to prevent blood clots that can lead to strokes.
Doctors are only recently understanding the importance of lifestyle factors in treating afib. Modifiable lifestyle factors are so important and under-recognized that the American Heart Association (AHA) recently released a scientific statement summarizing the latest research on this topic. The AHA wants both doctors and patients to understand the relationship between lifestyle and afib, and to work as a team to put these lifestyle factors into practice. Following is a discussion of important lifestyle factors, how they may impact afib, and what you can do.
One of the strongest factors associated with afib is body weight. Obesity (defined as body mass index [BMI] 30) has been shown in multiple studies to be linked to the development of afib. Obesity is associated with changes to electrical signaling within the atria, as well as structural changes to the heart’s upper chambers. Overeating can also cause inflammation via changes in hormone and cell-signaling pathways in the atria. Several studies have shown that as we gain weight, fat is deposited in the heart (as well as other places throughout the body), and this can trigger arrhythmias, most commonly afib.
Obesity can also be a cause of new or worsening hypertension (high blood pressure), which promotes further structural changes in the heart. Obesity also can cause obstructive sleep apnea and diabetes, both of which independently increase risk of afib.
The good news is that for people who are overweight or obese, just a 10% reduction in weight seems to improve symptoms related to afib.
For decades cardiologists have encouraged people to exercise, because exercise reduces the risk of dying from cardiovascular causes. Not only is exercise good, but physical inactivity is actually detrimental; a sedentary lifestyle contributes to afib and may actually be an independent predictor of this condition. The AHA recommends 150 minutes per week of moderate-intensity aerobic exercise, or 75 minutes per week of vigorous-intensity aerobic exercise, to improve cardiovascular health. Regular exercise helps to prevent atrial fibrillation and, if you already have afib, reduces symptoms and improves afib-related quality of life.