Which Comorbid Risks Are Making Your A-Fib More Severe? Do You Have Them Under Control?

Most A-Fib patients have at least one concurrent medical condition, i.e., comorbidity, that makes Atrial Fibrillation symptoms more severe and makes treating A-Fib more difficult with increased risk of complications. They can also affect the longevity of a treatment such as a catheter ablation.

Concurrent Medical Conditions

Concurrent conditions, or comorbidities, are risk factors that can interfere with the biological mechanisms or processes (pathogenesis) of your A-Fib. The leading concurrent conditions affecting Atrial Fibrillation patients are:

• Sleep Deprivation
• Obstructive Sleep Apnea
• Diabetes
• Hypertension (high blood pressure)
• Heat Failure
• Air pollution
• Respiratory Disease
• Chronic Kidney Disease
• Mental health disorders

Where to Start: When Was Your Last Physical Exam?

Check with your doctor or healthcare providers for the date of your last physical. If it’s been over a year, schedule an exam. You may find that you have undiagnosed conditions exacerbating your A-Fib.

Tip: You can request to have your blood draw/urine lab tests be done beforehand so you can discuss these findings during your physical exam along with the in-office testing.

At your exam, your blood pressure will be checked, an ECG of your heart taken, etc. revealing if there are undiagnosed problems. Blood draws and a urine sample will later reveal if you have hypertension, diabetes or kidney disfunction.

For obstructive sleep apnea, you may need to talk with your cardiologist/electrophysiologist to request testing.

Comorbidities and the Impact on Your Atrial Fibrillation

Sleep Deprivation: acute sleep deprivation increases your risk of A-Fib 3-fold; Most of us are now sleeping about 6.5 hours a night vs. in the 1960s we were sleeping 8.5 hours. To reduce the risk of A-Fib or lessen its symptoms, target rejuvenating, restorative sleep.

Obstructive Sleep Apnea (OSA): At least 43% of patients with Atrial Fibrillation also suffer from Obstructive Sleep Apnea. Patients with obstructive sleep apnea repeatedly stop and start breathing while they sleep. It occurs when the muscles supporting the soft tissues in the throat relax, the airway is narrowed, and breathing is momentarily cut off. Patients receiving CPAP therapy appear to have a lower risk of A-Fib recurrence after A-Fib ablation.

Obstructive sleep apnea can now be identified through an at-home sleep test (available by prescription). (Your cardiologist/electrophysiologist may need to order this test.) If diagnosed, more testing may be required to determine your treatment.

Diabetes Mellitus: Approximately 15% to 25% of patients with atrial fibrillation also have diabetes mellitus (a disease where the body cannot control blood sugar properly). It may predispose patients to structural, electric, and autonomic changes in the heart. Glycemic control has been associated with reduced risk of A-Fib. Blood sugar control may reduce episode frequency.

Hypertension (high blood pressure) is the leading modifiable risk factor for atrial fibrillation affecting an estimated 70% of A-Fib patients. Managing blood pressure should include the contributing lifestyle factors of obesity, physical inactivity, and diet.

Heart Failure: A-Fib and Heart Failure share common risk factors and frequently coexist. They can cause or exacerbate each other. It’s estimated that about 34% to 40% of A-Fib patients have or wil develop Heart Failure.

Air Pollution: Four meta-analyses have demonstrated that increased short-term exposure to air pollution is associated with a higher risk of A-Fib.

Respiratory Disease: Chronic obstructive pulmonary disease (COPD) is present in up to 23% of A-Fib patients, and COPD is associated with a 2-fold increase in A-Fib risk.

Chronic Kidney Disease (CKD) Approximately 30% of patients with Atrial Fibrillation also have Chronic Kidney Disease (CKD)—a condition where the kidneys are damaged and cannot filter blood well. CKD promotes A-Fib through chronic inflammation, volume overload, and electrolyte imbalances. Conversely, A-Fib reduces blood flow to the kidneys and increases the risk of ischemic stroke and heart failure.

Mental Health Disorders: Stress, psychological factors, and the state of one’s mental health can influence the occurrence, symptoms, treatments, and outcomes of A-Fib. The risk of A-Fib can be from alcohol or illicit substance misuse, lifestyle risks, or side effects of mental health medications.

What You Can Do to Lessen the Impact on Your A-Fib

It’s crucial to learn if you have any undiagnosed concurrent medical conditions and then get them under control. If needed, set up appointments to discuss any newly identified concurrent conditions. Your healthcare team can address each with appropriate medication, diet changes or other treatments, or referrals to specialists.

For your known comorbidities, review your current treatment plans for any adherence issues. Are you having difficulty with medication, following dietary plans or keeping appointments? Discuss with your doctors.

The Bottom Line on Comorbid Risks

Discovering unknown concurrent medical conditions and controlling known comorbidities can have a direct effect on your existing A-Fib symptoms, reduction in the frequency and intensity of episodes, maintenance of normal sinus rhythm and improved Quality of Life.

Take action to reduce the risk of these A-Fib-related complications, and improve your outlook for effective and long-term success of your A-Fib treatment plan.

Remember to Seek Your A-Fib cure. Don’t just aim to ‘manage’ your A-Fib with medications. It will all be worth it when you no longer suffer under the burden of Atrial Fibrillation.

Resources to Help You

Below are some resources to help you learn more about your Concurrent Medical conditions. (You can also open the drop-down ‘References’ tab below to see the many original research references used to write this article and read them yourself.)

Personal A-Fib Stories of Hope

Under our Personal A-Fib Stories of Hope, over 100 A-Fib patients have written about their journey to a life free from the burden of Atrial Fibrillation. You may find solace and encouragement and learn from their many ‘Lessons Learned’.

To help inspire you and help you find a story by subject matter, we cross-referenced stories by five major Themes/Topics. We encourage you to look for stories similar to your own. Go to Personal A-Fib Stories of Hope.

An Interview with Dr. John Mandrola: A-Fib Best Treated by Changes to Diet and Lifestyle, Says Dr. John Mandrola

Dr. John Mandrola, MD, cardiac electrophysiologist, Louisville, KY, on the impact of lifestyle factors on patients with atrial fibrillation, metabolic risk factors like obesity, poor diet, sleep apnea, alcohol intake, and lack of exercise;. Managing these risk factors can reduce the risk of stroke, and make a significant impact on the patient’s heart rhythm and overall health. (5:29)  Click here to go to video.

Reminder: Schedule a Physical Exam. You may find you have undiagnosed conditions exacerbating your A-Fib.

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