AFib and Fatigue Management
Although I’m a certified diabetes educator (CDE), my first couple of nursing jobs were on a telemetry unit. I worked as an LPN and an RN with heart patients – many of whom had atrial fibrillation (AFib).
Some of our AFib patients came in with dangerously high heart rates. One of the complaints I heard from these patients? “I was tired for a while; then I felt my heart fluttering and beating really fast, so I went to the emergency department."
So, what’s behind AFib and fatigue? It seems pretty common amongst AFib patients, so let’s take a look.
AFib by the Numbers
First, how common is AFib?
AFib is the most common heart arrhythmia. It affects anywhere from 2.7 million to 6.1 million Americans – and that number is only expected to rise as the population ages. It is estimated that two percent of the population under the age of 65 suffer from AFib, while nine percent of the population over the age of 65 have AFib.
AFib is responsible for approximately 750,000 hospitalizations yearly. It also contributed to 130,000 deaths annually. The death rate related to AFib (whether as the primary or contributing cause) has been increasing over the past 20 years.
And AFib is costly to Americans – it costs the US $6 billion annually. People with AFib incur an additional $8.705 in medical costs yearly, compared to their counterparts without AFib.
What Causes Fatigue?
Knowing how many people suffer from AFib, that is probably also a lot of people who are feeling fatigue!
So, what causes fatigue related to AFib?
This is a loaded question.
The patients that I was seeing as inpatients were coming in with critically high heart rates. What I mean by that is their hearts were beating at rates of upwards of 180 beats per minute. Keep in mind that the resting heart rate should be 60 to 100 beats per minute, depending on your health status. If your heart is beating 60 to 120 beats faster than normal, especially for an extended period of time, you’re going to feel fatigue. In a critical situation, we often call this “high-rate AFib" or “AFib with rapid ventricular response (RVR)."
But what if your heart isn’t beating rapidly and you feel fatigued?
Well, AFib can lead to heart failure. The heart isn’t beating effectively when it is in this abnormal heart rhythm.
According to the American Heart Association, “The heart is beating so fast that it never properly fills up with blood to pump out to the body… Oxygen-rich blood is not being delivered to the body and brain, causing physical and mental fatigue and reduced stamina. Fluid also can build up in the feet, ankles, and legs, causing heart-failure related weight gain."
If you’re not controlling your heart condition, you are setting yourself up for fatigue, as well as other complications.
How to Treat AFib-Related Fatigue
It should come as no surprise that if you have AFib, with or without fatigue, you should seek treatment from a cardiologist – specifically a cardiologist with expertise in treating AFib, called an electrophysiologist. An electrophysiologist can help to determine if you require advanced treatment options that require electricity, or if your heart rhythm can be treated with lesser options, such as medications.
Short of consulting an expert opinion, there are several things that you can do to promote better health – which can hopefully improve fatigue.
Improving your diet is important! If you take warfarin, you may need to watch your vitamin K intake, but that is beyond the scope of this article. However, a heart-healthy diet is recommended. This means limiting the amount of salt in your diet. You may choose to utilize salt substitutes and/or use other spices/seasonings and fresh herbs instead. Alcohol and caffeine are also known to trigger AFib, so limiting your intake, or cutting it out completely, is recommended.
Getting regular exercise is recommended for most individuals, although you should be cleared by your physician before beginning an exercise routine. Your physician should tell you what type of exercise and how much exercise is safe for you to do. According to the American Heart Association, regular physical activity is important because it…
- Helps you get a good night’s rest by regulating biological rhythms. This can combat fatigue.
- Helps you maintain a positive attitude.
- Can help you maintain (or lose) weight.
Relax when you need to. Depression and anxiety can lead to feelings of fatigue. They can also lead to feelings of helplessness and hopelessness. According to the American Heart Association, “To break the cycle, you will likely need a deliberate plan to schedule pleasant events. Make and follow a plan, even though you may not want to." Reach out for help if you need assistance.