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That Flutter in Your Heart: Are You In Love or Is It AFib?
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You’re sitting in your favorite chair reading a good book and drinking a cool beverage, completely relaxed. Suddenly, your heart races without warning, then slows. It races again, as if it is shivering uncontrollably inside your chest.

What you are feeling is an arrhythmia, most commonly known as an irregular heartbeat. You might also experience the sensation when exercising or lying down.There are several different types of arrhythmias, but the most common type is atrial fibrillation or AFib, affecting 2.2 million Americans each year — a number which the National Heart Lung and Blood Institute estimates will double by 2020. An AFib patient may describe her arrhythmia as feeling like the top part of her heart is quivering very fast, like shaking a bowl of Jell-O. This occurs when the two upper chambers of the heart, known as the atria, quiver rapidly rather than beating normally.

What makes AFib dangerous is that blood is not completely pumped out of the atria, allowing it to clot, which can then lead to a stroke. Men are more likely to have AFib, but women have an increased risk of stroke or death as a result of the condition. In 2009, a study published in Gender Medicine found that women with AFib are less likely to be prescribed blood thinners than men and also have a greater risk of bleeding from anticoagulation therapies, thereby increasing stroke risk. Dr. Annabelle Volgman, medical director of the Heart Center for Women at Rush University Medical Center and the study’s lead investigator, warned "Women are at higher risk of atrial fibrillation-related stroke than men and are more likely to live with stroke-related disability which can significantly lower quality of life.”

The Rush University study reviewed 20 years of gender differences in atrial fibrillation and recommended several ways to manage AFib in women, including careful monitoring of antiarrhythmic drugs, which can cause life-threatening arrhythmias in women; increased awareness of hormonal fluctuations during menstrual cycles that can affect heart rates; and checking for low potassium levels which may cause drug-related arrhythmias. Says Dr. Volgman, "For women with atrial fibrillation, these gender differences should always be kept in mind to help prevent strokes and heart failure and improve their quality of life.”

AFib is more common among women who are over 65, and those with hypertension or diabetes are at increased risk. Many doctors believe that high levels of caffeine may occasionally contribute to AFib and some people can also experience temporary atrial fibrillation as a result of heavy drinking, commonly referred to as "holiday heart”. However, Marco R. Di Tullio, M.D., Director of Echocardiography Research at Columbia University Medical Center, advises women that "In many cases the onset of atrial fibrillation may occur without any particular trigger.”

Meanwhile, several pharmaceutical companies are currently developing new drugs that may better control cardiac rhythm and reduce bleeding risk, and the future may hold completely new therapies. "Researchers are constantly looking for newer and better ways to treat atrial fibrillation and prevent its consequences,” says Dr. Di Tullio. "The study of genetic and molecular determinants of atrial fibrillation might open the way for novel approaches to its prevention and treatment.” Until then, pay attention to that pitter-pat.

Signs and Symptoms of Atrial Fibrillation:

Although AFib can be successfully treated through medication, electrical cardioversion, or surgery, it often presents itself as asymptomatic or "silent”, meaning that many women do not even realize that they have it at all. Sometimes the condition is only discovered through a routine physical exam. AFib can be either chronic: symptoms lasting continuously until treated; or paroxysmal: symptoms that come and go, ranging from a few minutes to a few hours before ending.

Common symptoms:

• heart palpitations

• dizziness

• shortness of breath

• fatigue

• chest pain

You should schedule an appointment with your health care provider if you are experiencing these symptoms; an EKG (electrocardiogram) can identify AFib.

However, if you are experiencing chest pain, call 911 immediately.

Resources and News on AFib:

Atrial Fibrillation Overview

Women With Atrial Fibrillation Are At Significantly Higher Risk Of Stroke And Death Compared To Men

Recovery Act Investments in Atrial Fibrillation (AFib)

The Race to Replace Warfarin

A new era for patients with atrial fibrillation

Canada approves Medtronic device to treat atrial fibrillation

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WomenHeart: The National Coalition for Women with Heart Disease is a nonprofit, 501(c)(3) patient advocacy organization with thousands of members nationwide, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. WomenHeart supports, educates and advocates on behalf of the nearly 48 million American women living with or at risk of heart disease. Our programs are made possible by donations, grants and corporate partnerships.

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WomenHeart: The National Coalition for Women with Heart Disease is a founding partner of The Heart Truth Red Dress campaign. The Heart Truth and Red Dress are trademarks of HHS.