Atrial Fibrillation
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HOW DO YOU GET A-FIB (CAUSES)?
    Nearly three million people in the U.S. have A-Fib. By the year 2050, the number will be 5.6 million.⁷¹ This year there will be over 340,000 new cases in the US. A-Fib is the most common heart arrhythmia.¹⁴⁶ Americans over 40 have a one in four lifetime risk of developing A-Fib.⁸²
    If you've had other heart problems, this could lead to diseased heart tissue which generates the extra A-Fib pulses. Hypertension (high blood pressure), Congestive heart Failure, and Mitral Valve disease seem to be related to A-Fib, possibly because they stretch and put pressure on the pulmonary veins where most A-Fib originates. Many people ("up to 40% of patients"⁴²) get A-Fib after open heart surgery. "Pericarditis"---inflammation of the pericardium, a sack-like membrane surrounding the heart---can lead to A-Fib.
   
    Heavy drinking may trigger A-Fib, what hospitals call "holiday heart"---the majority of A-Fib admissions occur over weekends or holidays when more alcohol is consumed.
    Extreme fatigue, emotional stress, severe infections, severe pain, and illegal drug use can trigger A-Fib. Low or high blood and tissue concentrations of minerals such as potassium, magnesium, iron and calcium can trigger A-Fib. Thyroid problems (hyperthyroidism), lung disease, reactive hypoglycemia, viral infections and smoking can trigger A-Fib. Smoking cigarettes raises the risk of developing A-Fib even if one stops smoking, possibly because past smoking leaves behind permanent fibrotic damage to the atrium which makes later A-Fib more likely.¹²⁹
    Some research has identified a Familial A-Fib where A-Fib is passed on genetically²⁸ but it is relatively rare.
    Some cases have been reported where antihistamines, bronchial inhalants, local anesthetics, tobacco use, MSG, cold beverages, and even sleeping on one's left side or stomach are said to have triggered A-Fib. The author used to include caffeine (coffee, tea, sodas, etc.) in this list, but some research suggests that coffee and caffeine in moderate to heavy doses (2-3 cups to 10 cups/day) may not trigger or induce A-Fib.^{144, 145} Coffee (caffeine) may indeed be antiarrhythmic and may reduce propensity and inducibility of A-Fib both in normal hearts and in those with focal forms of A-Fib.¹⁴³ (Thanks to Karl for calling our attention to these articles.)
    Chocolate in large amounts may trigger attacks. Chocolate contains a little caffeine, but also contains the structurally related theobromine, a milder cardiac stimulant (thanks to Prof. Phil Page from the UK for this info). GERD (heartburn) and other stomach problems (like H. pylori) may be related to or trigger A-Fib. If so, antacids and proton pump inhibitors like Nexium may help your A-Fib (Thanks to Ian Betts for this observation). A recent report from England suggests that the veterinary antibiotic "Lasalocid" found in eggs and poultry meat may cause or trigger A-Fib.⁶⁵ One person writes that hair regrowth products seem to trigger his A-Fib.
    Recent research indicates sleep apnea (where your breathing stops while you are sleeping) may contribute to A-Fib.⁹⁰ Many people have sleep apnea and don't know it. Your significant other can tell you if you snore a lot, which is often a sign of sleep apnea. If you have A-Fib, it might be wise to have yourself checked for sleep apnea. (Thanks to David Embler for this observation.) (Gail writes that both her sleep apnea and her A-Fib were cured by a CPAP [Continuous Positive Airway Pressure] breathing machine. E-mail: gail(at)bonairwine.com [the "@" is written as "(at)" to avoid access by spam mailing lists].)
    If your A-Fib episodes occur usually at night, after a meal, when resting after exercising, or when you have digestive problems, you may have Vagal A-Fib. (See Vagal A-Fib)
    Athletes are more prone to A-Fib perhaps because they have larger hearts where there is more room for these extra electrical signals to develop and propagate, and possibly because of the extra pressure they put on their pulmonary veins through aerobic exercise. A-Fib is often found in tall people, particularly basketball players.⁸⁹ Men get A-Fib more than women.
    A-Fib is associated with aging of the heart. As patients get older, the prevalence of A-Fib increases, roughly doubling with each decade. 2-3% of people in their 60s, 5-6% of people in their 70s, and 8-10% of people in their 80s have A-Fib.^68,69,70 This suggests that A-Fib may be related to degenerative, age-related changes in the heart. Inflammation may contribute to the structural remodeling associated with A-Fib.⁸²
    But in many A-Fib cases (around 50% of Paroxysmal A-Fib⁴⁴), there is no currently discernible cause or trigger (called "Lone" or "Idiopathic A-Fib").²⁶ (Some research suggests that inflammation may initiate Lone A-Fib.⁸⁴)

(Last updated 5/11/09)

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