This is probably because months and years of intense training may have caused stretching of the upper chambers of the heart , which can lead to them having slightly dilated or enlarged atria . Over time , this may cause small areas of scarring that will go on to trigger AF .
Treatment for AF very much depends on the patient ’ s symptoms and their profile . When older patients present with mild symptoms , identifying the risk of stroke is a priority so they can be started on blood-thinning medicine .
Treatment for AF also depends on the type of AF the patient has . For paroxysmal AF , meaning it comes and goes between normal and abnormal rhythm , the patient would require specific anti-arrhythmic medication such as flecainide , propafenone or sotalol . For people who have AF all the time , rate-slowing medicines such as beta blocker or digoxin would be prescribed .
Many patients , especially younger ones , do not want to take long-term medicine , especially as medicine reduces the symptoms but it cannot cure the condition . Instead , they would prefer a longer-term cure such as catheter ablation .
Catheter ablation is a procedure that very carefully destroys the diseased area of the heart and interrupts abnormal electrical circuits .
In the procedure , thin wires are guided through one of the veins into your heart , where they record electrical activity .
When the source of the abnormality is found , an energy source , such as high-frequency radio waves that generate heat , is transmitted through one of the catheters to destroy the tissue .
“ Younger patients are the better group for considering catheter ablation . The older group , such as patients over 65 to 70 , may still have catheter ablation , although the risks are slightly higher in that group ,” said Dr Liew .
In younger patients who are generally well and don ’ t really have serious heart problems other than AF , the most important thing is to control AF symptoms so they can get on with their normal life .
Maintaining a healthy lifestyle is an extremely important factor for anyone diagnosed with AF at any age . Patients who are overweight should turn to exercise and healthy eating in an effort to lose weight , since obesity is one of the reasons why AF can persist or get worse .
“ I always tell patients that we don ’ t want their condition to suppress their lifestyle ,” said Dr Liew , adding that if they enjoy exercise , travelling or going out , they shouldn ’ t stop .
“ But they must still keep up with their regular exercises , which will help with the vascular system and control their blood pressure .”
Another important consideration is the consumption of alcohol and caffeine . Although some studies suggest a small amount of alcohol may be beneficial for the heart , when it comes to arrhythmia , such as AF , any alcohol can make the condition worse .
It may take just one glass of wine to trigger AF for some patients , while others can take more . Often , drinking at a party can cause an episode , and most patients will eventually know their limits .
The frequency of AF episodes depends on the individual , as well as their lifestyle at the time of the episode . Some may have one once a year , for example ; others every four or five months . When they start drinking more frequently , they may say it comes on every week , and it might last for a few hours .
“ The frequency and duration are very important ,” said Dr Liew . “ Often , when we see patients , we will ask how often they get symptoms and how long they last for . Can they think of anything that will make it worse , trigger it or make it last longer ?”
In addition to drinking more than usual an episode may stem from taking long-distance flights and being jetlagged . Poor sleep habits also contribute to AF , as does stress at work .
“ It ’ s a very strange condition in that there are lots of triggers that can make things worse for patients . Some patients drink green tea , and that makes it worse . I have one patient who says it gets worse in cold weather . There are different triggers for different people .”
Generally , a good diet for AF patients would be one that keeps weight down and is accompanied by good supplements for their body . For example , a mixed , low-cholesterol diet including fruit and vegetables , fish , nuts , and low in fried and fatty foods would be ideal . Any sustained consumption of food that worsens blood pressure and increases the risk of coronary artery disease would also make AF worse , because the condition is intrinsically linked with hypertension and increased weight .
“ The current recommendation by a lot of medical bodies is the Mediterranean diet , which is high in legumes , nuts and polyunsaturated oils such as olive oil . The olive oil really makes a difference ,” said Dr Liew .
Make an appointment to consult a cardiologist at Mount Elizabeth Hospitals
Phone Appointment : + 65 6250 0000 ( Orchard ) Whatsapp Appointment : + 65 8111 7777 ( Orchard ) Online Appointment : www . mountelizabeth . com . sg
Dr Reginald Liew is a cardiologist at Mount Elizabeth Hospitals in Singapore . He ’ s an expert in cardiac electrophysiology and the director of The Harley Street Heart and Vascular Centre in Singapore .
GlobalHealthAsiaPacific . com DECEMBER 2021 - JANUARY 2022