Introduction
Life expectancy in atrial fibrillation depends on the type of arrhythmia and the treatment options. If there is cardiac disease in addition to atrial fibrillation, life expectancy decreases compared to healthy people. However, due to the treatment options available today, life expectancy is significantly higher than it was 50 years ago.
Does atrial fibrillation reduce my life expectancy?
There are different forms of atrial fibrillation, which are based on different causes. Life expectancy is highly dependent on accompanying heart disease. Coronary heart disease (CHD) is the main cause of atrial fibrillation and can be positively influenced by a healthy lifestyle. With a weakened heart and atrial fibrillation, mortality is increased. If you are younger than 65 years of age and suffer from atrial fibrillation and are otherwise heart healthy, you have a similar life expectancy as people without atrial fibrillation despite the fibrillation.
Which forms of atrial fibrillation have a particularly negative effect on my life expectancy?
Atrial fibrillation can be differentiated according to the time and duration of its occurrence in
- Paroxysmal atrial fibrillation (occurs in attacks and disappears by itself)
- Persistent atrial fibrillation (lasts longer than 7 days, is treatable)
- Permanent atrial fibrillation (persists permanently and is resistant to therapy)
Paroxysmal atrial fibrillation (paroxysmal = seizure-like) occurs suddenly and usually disappears on its own within 48 hours and at most within 7 days. Paroxysmal atrial fibrillation very often remains undetected. It is assumed that people with paroxysmal atrial fibrillation have a similar risk of stroke as patients with permanent atrial fibrillation.
The symptoms of atrial fibrillation can be non-specific: irregular heartbeat and pulse, dizziness, sweating, shortness of breath, restlessness or fatigue. As a result, this form, which quickly goes away on its own, is often overlooked. The paroxysmal atrial fibrillation can become chronic over time.
Persistent atrial fibrillation (persistent = persistent/permanent) lasts for more than 7 days and can be stopped by medical means. Persistent atrial fibrillation can last for more than a year without treatment. This form of the disease is usually treated by drug or electrical cardioversion.
Persistent atrial fibrillation (permanent = permanent) is diagnosed when persistent atrial fibrillation is accepted by the patient and no treatment is given to normalize the rhythm. If atrial fibrillation persists for more than 48 hours, the risk of developing a blood clot is greatly increased. The blood clots can break off and be washed away via the vessels, which can then cause vascular occlusion (embolism).
If an embolism or even a stroke occurs, this is bad for life expectancy. Therefore, it is important to diagnose atrial fibrillation early and to treat it specifically with blood thinning and rhythm restoration if necessary. The duration of atrial fibrillation is therefore particularly important for life expectancy, as it has a major influence on the risk of embolism and stroke.
Prolonged atrial fibrillation without treatment has a negative effect on life expectancy. Atrial fibrillation can also be divided into “classic valvular atrial fibrillation” and “non-valvular atrial fibrillation” (valvular = concerning a heart valve). This historical subdivision establishes a connection between atrial fibrillation and pathological changes in the heart valves. In “classic valvular atrial fibrillation”, atrial fibrillation occurs when the mitral valve is narrowed (mitral stenosis) or after a mechanical heart valve replacement. These heart valve diseases, which fall under this definition, have an increased risk of thromboembolic events compared to “non-valvular atrial fibrillation”.
