What are the chances my AF will become permanent?

Summary

Dr. Sanjay Gupta, a cardiologist, addresses common concerns about atrial fibrillation (AF) in this informative video. He explains the progression from paroxysmal AF to persistent or permanent AF, reassuring viewers that while the latter may seem daunting, many patients adapt well to it. Citing the Canadian AF registry, Dr. Gupta reveals that around 36% of patients with paroxysmal AF may develop permanent AF over ten years, with certain factors increasing the risk. He emphasizes that people in permanent AF often tolerate it better than they expect and encourages viewers to seek more information via his website and social media.

Takeaways

• 😀 Atrial fibrillation (AF) is a common condition, with paroxysmal AF causing sudden, uncomfortable episodes of irregular heartbeats.
• 😀 Many people with paroxysmal AF fear that their condition will progress to persistent or permanent AF, but this is not always the case.
• 😀 Surprisingly, many people tolerate permanent AF better than expected. The irregular rhythm becomes their 'normal', and the body adapts.
• 😀 When a person moves from paroxysmal to permanent AF, the main concern shifts to controlling the heart rate to prevent discomfort, using treatments like beta-blockers.
• 😀 The chances of paroxysmal AF progressing to permanent AF increase over time: 8% at one year, 12% at two years, and 25% at five years.
• 😀 By ten years, around 36% of people with paroxysmal AF will progress to permanent AF, but this isn't guaranteed for everyone.
• 😀 Factors that increase the risk of progression to permanent AF include larger atrial size, increasing age, high blood pressure, heart failure, and valve disease (such as mitral stenosis).
• 😀 Even if someone progresses to permanent AF, many find that it is more manageable than they initially feared, with fewer sudden, unpredictable episodes.
• 😀 The Canadian AF registry is one of the studies showing that about 1 in 4 people will progress to permanent AF within five years.
• 😀 Dr. Sanjay Gupta encourages people with AF to share their stories on his new website and mentions his availability on Instagram for short health videos.

Q & A

What is atrial fibrillation (AF)?

Atrial fibrillation is a heart condition where the heart beats irregularly and often rapidly. This can cause discomfort, palpitations, breathlessness, and fatigue.

What is the difference between paroxysmal and persistent atrial fibrillation?

Paroxysmal atrial fibrillation involves sudden, unpredictable episodes where the heart rate increases and then returns to normal by itself. Persistent atrial fibrillation is continuous and requires medical intervention to manage or treat the irregular heart rhythm.

Why do people with paroxysmal atrial fibrillation fear it becoming permanent?

People fear their condition becoming permanent because during paroxysmal atrial fibrillation, the sudden, unpredictable jumps from normal to abnormal rhythms are distressing. They worry they will feel uncomfortable or unwell all the time if it becomes persistent.

How well do people tolerate permanent atrial fibrillation?

Surprisingly, many people tolerate permanent atrial fibrillation better than expected. Although the rhythm is irregular, the body adapts, and the rhythm becomes the normal one. Many individuals do not even realize they are in atrial fibrillation, and their symptoms may be less intense once the irregularity is consistent.

What percentage of people with paroxysmal atrial fibrillation progress to permanent atrial fibrillation over time?

According to the Canadian AF registry, about 8% of patients with paroxysmal atrial fibrillation develop permanent atrial fibrillation after one year. This increases to 12% after two years, 18% after four years, 25% after five years, and 36% after ten years.

What factors increase the likelihood of progressing to permanent atrial fibrillation?

Risk factors include larger atria, increasing age, high blood pressure, heart failure, valve diseases like mitral stenosis or aortic stenosis, and a leaky mitral valve.

How do people with permanent atrial fibrillation usually manage their condition?

Treatment typically focuses on controlling the heart rate and preventing the heart from racing while in atrial fibrillation. Medications such as beta blockers are commonly used to help manage symptoms and improve tolerance.

Can people with permanent atrial fibrillation live without noticing the condition?

Yes, many people with permanent atrial fibrillation live with it without even knowing they have it, especially if their symptoms are well-managed through medications and their body has adapted to the irregular rhythm.

What role does the heart's size play in the progression of atrial fibrillation?

Larger atria (specifically when the left atrial size exceeds 5 centimeters) are associated with a higher risk of progression to permanent atrial fibrillation.

Where can patients find more information or reach out to you for consultations?

Patients can visit the website www.mycardiologist.com for patient stories, helpful resources, and contact details. Additionally, Dr. Sanjay Gupta is active on Instagram, where he shares short health videos, and patients can reach out through the website for consultations.