Many people live for years with AFib without problems. Symptoms of AF related to the fast heart rates, relative mechanical inefficiency of the ventricles resulting in decreased cardiac output. This can result in poor circulation the brain, muscles and other parts of the body.
Prolonged arrhythmia at very fast heart rates can affect the cardiac muscle contractility causing congestive heart failure.
However, chronic atrial fibrillation can result in future problems:
- Risk of stroke: Known risk factors for stroke include male sex, valvular heart disease (rheumatic valvular disease), CHF,
hypertension, and diabetes. Additional risk factors, such as advanced age and prior history of stroke, diabetes, and hypertension, place
patients with preexisting AF at even higher risk for further comorbidities such as stroke. Patients with nonvalvular AF and risk factors have a 5-fold increased risk for stroke. Patients with rheumatic heart disease and AF have an even higher risk for stroke (17-fold). At least 4 large clinical trials have clearly demonstrated that anticoagulation with warfarin decreases the risk of stroke by 50-80%.
- Because the atria are beating rapidly and irregularly, blood does not flow through them as quickly. This makes the blood more
likely to clot. If the clot is pumped out of the heart, it can travel to the brain, resulting in a stroke. People with atrial fibrillation
are five to seven times more likely to have a stroke than the general population. Clots can also travel to other parts of the body (kidneys,
heart, intestines), causing damage.
- Congestive heart failure: Rapid heart beat for prolonged periods of time can result in significant stunning of the heart muscle which in turn affects its contractility. This rapid heart rate mediate heart failure is called as Tachycardia mediated cardiomyopathy.
- Longstanding atrial fibrillation is associated with an increased risk of death due to systemic thromboembolization and heart failure.
- Impact on Quality of Life: AF is also known to affect patients on the psychological front causing increased anxiety and depression.