Prophylaxis
The best prevention against atrial fibrillation is to avoid or control the triggering factors. For example, high blood pressure or many heart diseases can be largely prevented by a healthy and balanced lifestyle. Pay particular attention to your weight, healthy nutrition and sufficient exercise. Apart from that, there is unfortunately no suitable prophylaxis.
Prognosis
Ultimately, the prognosis depends on the underlying human disease and therefore cannot be generalized. For example, patients with pronounced cardiac insufficiency and accompanying atrial fibrillation have significantly worse prospects than people who suffer from atrial fibrillation at times due to hyperthyroidism. Patients suffering from atrial fibrillation have an increased risk of suffering a stroke.
Due to the flickering movement of the atria, blood clots (thrombi) can form in the heart relatively quickly. If such a clot breaks away from the heart wall and flows with the bloodstream, it can reach the vessels supplying the brain and block one of the vessels. The clot then sits like a plug in the lumen of the vessel and, in the worst case, closes it completely so that no more blood can flow through this vessel.
In the case of a brain-supplying vessel, this means that the area of the brain that is supplied by this blood vessel is no longer supplied with blood, resulting in so-called ischemia. This leads to various symptoms of a stroke. Which symptoms occur depends largely on which blood vessel in which area was blocked by the clot.
In order to drastically reduce the risk of stroke in patients with atrial fibrillation, the use of blood thinners is recommended for most patients with atrial fibrillation. There is a score that is used to assess the risk of developing a stroke in patients with atrial fibrillation. This score also gives a recommendation as to whether or not blood thinning (anticoagulation) is recommended.
This score is referred to as the CHA2DS2 Vasc-Score in its extended form. The individual letters are acronyms for diseases. Since the score is stolen from English, the respective letter does not always match the corresponding disease in German language.Patients suffering from congestive heart failure are awarded one point.
Patients with high blood pressure (hypertension) receive one point. Patients with an age over 75 years receive two points, therefore the 2 behind the A. Patients with diabetes mellitus receive one point.
Patients with a stroke or a TIA (transient ischemic attack, “minor shag attack”) in their history receive two points, hence the 2 behind the S. V stands for vascular and refers to vascular diseases. Patients with pre-existing vascular diseases such as coronary heart disease (CHD) or peripheral arterial occlusive disease (PAD) receive one point. Patients between 65 and 74 years (A) receive one point.
Female patients (sex = gender) receive one point. The number of points achieved can be between 0 and 9 points. Patients with 0 points do not need blood thinning.
Female patients who have received a point based on their sex can be treated as 0 points, so they do not need blood thinning. Blood thinning is recommended from 1 point on. With exactly 1 point, this could theoretically also be done with ASS (Aspirin®).
From 2 points on, oral anticoagulation must be initiated – if there are no contraindications. New oral anticoagulants or vitamin K antagonists are the means of choice here. In principle, atrial fibrillation does not limit the life expectancy of an otherwise healthy patient.
However, life expectancy can be reduced, especially in patients who suffer from numerous (cardiac) pre-existing conditions and for whom atrial fibrillation is not treated. Overall, untreated atrial fibrillation is considered a risk factor, as it can trigger a stroke, for example. This in turn can have a significant impact on life expectancy.
Atrial fibrillation should therefore always be treated – except in exceptional cases. This is done by diluting the blood. Patients whose heart beats too quickly during atrial fibrillation or who experience symptoms due to atrial fibrillation must be treated with other medication in addition to blood thinning.
Nowadays, treated atrial fibrillation rarely reduces life expectancy. Interesting information can also be found here: Consequences of cardiac dysrhythmiaAtrial fibrillation sounds to the layperson similar to ventricular fibrillation. However, they are two completely different cardiac arrhythmias.
While atrial fibrillation takes place in the atrium, the center of ventricular fibrillation is in the ventricle. Ventricular fibrillation is a life-threatening cardiac dysrhythmia that usually requires defibrillation (shock delivery to the heart) to bring the heart back into the correct rhythm. Ventricular fibrillation is a common cause of what is commonly known as cardiac arrest, a life-threatening circulatory disorder.
Atrial fibrillation, on the other hand, carries only a very low risk of developing into ventricular fibrillation and is therefore rarely directly fatal. However, especially in patients with a damaged heart who are suffering from atrial fibrillation with a heart rate that is too fast, it can be dangerous because the heart can become “exhausted”. This can ultimately lead to acute heart failure.
However, this is rarely the case. However, atrial fibrillation also increases the risk of a stroke. In the worst case, this too can be fatal.