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Atrial fibrillation tends to course episodically, particularly in the early stages (paroxysmal or persistent). However, the circumstances that trigger an episode of atrial fibrillation often cannot be identified, while on other occasions they are quite evident. Furthermore, it is sometimes impossible to prevent the triggering factors (e.g. an episode while asleep), but sometimes the risk can be minimised or prevented (e.g. by avoiding large meals, alcohol and excessive strain).
How to respond to a crisis of atrial fibrillation
Take an additional dose of your antiarrhythmic treatment, if indicated by your healthcare team. If you have other symptoms such as dizziness, chest pain or difficulty breathing, you have to go to the emergency department immediately. In many cases the episode of atrial fibrillation will disappear by itself in a short while (within a few minutes or 2–3 hours). The patient is often familiar with the typical evolution and duration of their episodes of atrial fibrillation.
If it is clearly an episode of atrial fibrillation and there are no other symptoms, patients should wait for a short period before going to an emergency department.
Toxic agents. Excessive alcohol consumption may provoke episodes of atrial fibrillation, even in people who do not have a heart problem. Smoking increases the risk of atrial fibrillation, due to both its direct toxic effects and the damage it causes to the coronary arteries. Weight loss in people with obesity, plus a reduction of the associated factors such as high blood pressure and a sedentary lifestyle, is known to decrease the recurrences of atrial fibrillation and significantly improves the results of treatment.
Diet. Following a balanced diet and avoiding being overweight or obese are important factors that prevent the onset of atrial fibrillation, reduce the risk of recurrences and improve treatment effectiveness.
Exercise. Physical activity provides a dual effect. On one hand, moderate physical exercise (walking quickly or jogging slowly) helps prevent recurrences of atrial fibrillation and improves control over risk factors: it helps with weight loss, reduces blood pressure and controls glycaemia in the case of diabetes. On the other hand, high-intensity physical exercise (especially endurance exercises: running, cycling, and so on) increases the risk of atrial fibrillation.
Sleep. Sleep apnoea (snoring) is a risk factor for developing atrial fibrillation. Patients who suffer excessive daytime drowsiness, unrefreshing sleep or snoring should discuss it with their healthcare team, especially if they have obesity or high blood pressure.
Sexuality. A diagnosis of atrial fibrillation does not imply any contraindication for maintaining sexual relationships.
Travel. Having atrial fibrillation does not generally mean patients must stop travelling. If you are taking anticoagulants such as Sintrom®, Aldocumar® or similar, you must remember to check your clotting status during the trip, if necessary. Given that the formulations of anticoagulants and antiarrhythmic agents can vary between countries, you should take enough doses with you to cover the entire trip. It is also a good idea to carry an up-to-date medical report.
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Substantiated information by:
Alba Cano VallsNurseAtrial Fibrillation Unit
Eduard Guasch CasanyMédico Cardiólogo, HCBUnidad de Fibrilación Auricular
Josep Lluís Mont GirbauCardiologistAtrial Fibrillation Unit
Manel Castellà PericasCardiac SurgeonCardiovascular Surgery Head of Department
Published: 27 November 2018
Updated: 27 November 2018
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