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 FAQs Understanding A-Fib: Stiff Heart

FAQs Understanding Your A-Fib A-Fib.com7. I’ve heard about ‘stiff heart’ or diastolic dysfunction. When you have A-Fib, do you automatically have diastolic heart failure? What exactly is diastolic dysfunction?

Someone with A-Fib can have much the same symptoms as someone with a ‘stiff heart’ or diastolic dysfunction. But A-Fib is an electrical problem that is often fixable, whereas diastolic dysfunction is a structural (or plumbing) problem usually not easily fixed.

Here are some statements from doctors I asked about this question:

• “Diastolic dysfunction (stiff heart) can lead to congestive heart failure. A-Fib is electrical. But some patients with A-Fib also have diastolic dysfunction.”

• “While many people with A-Fib do indeed have diastolic dysfunction (usually as a result of hypertension), this is not always the case.  On the other hand, there is no doubt that hypertension and the consequent effect on atrial stretch exacerbates the situation.  Perhaps the best way to think about it is that based on one’s genetic predisposition, one has a certain propensity to develop A-Fib. This can be modulated (i.e., exacerbated) by conditions that increase atrial pressure—such as hypertension, valve disease, heart failure, etc.”

Diastolic dysfunction refers to a decline in performance of one or both ventricles. ‘Diastole’ refers to the time when the ventricles are relaxing and filling with incoming blood as compared to when the ventricles are propelling blood out to the rest of the body. Diastolic Dysfunction may refer to both the left atrium and left ventricle being stiff and not functioning properly. (Whereas in A-Fib the focus is on the left atrium.)

When someone in A-Fib is restored to normal sinus rhythm, usually both the left atrium and left ventricle begin to function normally again. But someone with long term A-Fib may also develop an anatomical or mechanical pumping problem—diastolic dysfunction (stiff heart), fibrosis, scarring, cardiomyopathy, etc. which are more permanent and harder to improve. (Another reason to treat your A-Fib as soon as possible.)

Last updated: Monday, February 13, 2017

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