AFib and Congestive Heart Failure

Considering overall heart health, there are often other heart  issues that go along with atrial fibrillation. A common condition those living with AFib often face is congestive heart failure, commonly known as CHF. CHF often refers to a weak heart but can also signify a stiff heart, meaning it doesn’t pump blood efficiently throughout the body.  

This can lead to back-flow, causing fluid buildup in the lungs or swelling of the legs, which are the most common symptoms of congestive heart failure.

How Does Atrial Fibrillation Affect Congestive Heart Failure?

It can be the primary cause of congestive heart failure

Sometimes people are first diagnosed with atrial fibrillation, they don’t necessarily feel their heart beating fast or irregular, they only notice an increasing shortness of breath. So, when they are finally diagnosed, their heart may have had this rapid heart beat for a few weeks or even months at a time. As a result, heart function becomes weaker than normal.

Once coronary artery disease is ruled out, this condition is referred to as tachycardia-mediated cardiomyopathy. This implies that the rapid heart rate, or tachycardia, from AFib is what has primarily caused CHF. There are a few ways to manage this. One way is ensuring your heart rate is under control. Over time, you can help your heart get stronger again. However, rhythm control, whether it is a procedure or a cardioversion to get a patient out of AFib, tends to help better to improve your heart function and return it to as close to normal as possible.

It can be secondary to congestive heart failure

Having a weak or stiff heart can cause elevated pressure in your heart, not only on the top chambers of the heart but on the bottom chambers as well. Over time, this ends up dilating the upper chambers and leads to signs of atrial fibrillation. In this scenario the AFib is secondary to the CHF.  However, when something like this happens the heart tends to get even weaker and you get more symptoms and more shortness of breath, even if someone already has CHF. Patients who have CHF as well as AFib are more likely to have severe symptoms and more likely to be hospitalized. Trying to keep a regular heart rhythm keeps the amount of normality that your heart may still have. There has been recent data that shows managing a patient’s AFib who also has CHF, can significantly reduce rates of hospitalization. In this scenario, rhythm control, or trying to maintain normal rhythm as much as possible, works best to reduce rates of hospitalization for patients that have CHF.

In this core series of videos I discuss what is atrial fibrillation and the core concepts that every patient should know about AFib.

In both these scenarios, an ablation procedure may help maximize the heart’s normal rhythm and improve symptoms. However, this can be an aggressive procedure and has a longer recovery period for someone already experiencing congestive heart failure.

In these settings not everyone who has congestive heart failure is a candidate for an ablation. If you choose that route you need to make sure your heart is as ‘tuned up’ as it can be and breathing is as regular as possible leading up to the procedure. The best result would be to consult with your doctor to see if an ablation procedure would best suit you and your symptoms.

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