Managing Atrial Fibrillation: A Comprehensive Guide for Patients

Q: Managing Atrial Fibrillation: A Comprehensive Guide for Patients

We recommend that you： 1. <br>Discuss the above situation further with your attending physician, focusing on symptomatic treatment, or see if further examinations are necessary! Thank you, and wish you good health!

Atrial fibrillation

Hello, Doctor.
I usually have a habit of running, but I overtrained before.
After working shifts for a year, I started feeling a foreign body sensation in my right eye about six months in, which led to eyelid twitching.
I used eye drops for a while and supplemented with fish oil, which helped somewhat, but I still feel the foreign body sensation, especially when looking at the upper left corner, where I also experience double vision.
My right eye has limited movement.
Additionally, I have had chronic lower back pain upon waking up.
I have visited orthopedic specialists multiple times and had an MRI, but nothing was found.
The doctor said it is inflammatory back pain and I can only take anti-inflammatory medication.
My left hip also often hurts.
Over the past few years, my health check-ups have shown inflammatory markers consistently above 600.
The doctor mentioned it might be caused by exercise but did not provide further guidance.
I stopped working shifts last month, but I have been experiencing insomnia and taking sleeping pills without much improvement.
The doctor said it is due to anxiety, but I can feel my heartbeat during the day and night.
Initially, the doctor said it was premature contractions, but after a 24-hour ECG, they diagnosed me with atrial fibrillation.
I can feel my heart rate being unstable throughout the day, with an extra beat between regular beats.
My normal heart rate is 50-60 bpm, dropping to 40-45 bpm while sleeping, and 70-90 bpm when moving.
This often occurs when I change positions.
I am taking Dronedarone and anticoagulants.
I have issues with my eyes, back, hip, and heart, and I am unsure which specialist to consult.
I was considering going to the Veterans General Hospital for an electrophysiology study.
I hope you can provide me with some advice.
Thank you, Doctor.

Yongzhe Wudi, 40~49 year old female. Ask Date: 2022/11/17

Dr. Chen Jili reply Cardiology

We recommend that you: 1.
Discuss the above situation further with your attending physician, focusing on symptomatic treatment, or see if further examinations are necessary! Thank you, and wish you good health!

Reply Date: 2022/11/17

More Info

Managing atrial fibrillation (AF) can be complex, especially when it coexists with other health issues such as heart failure, chronic pain, and anxiety. Your situation highlights the importance of a comprehensive approach to treatment and management. Here’s a detailed guide to help you understand AF and how to manage it effectively.

Understanding Atrial Fibrillation
Atrial fibrillation is an irregular and often rapid heart rate that can lead to various complications, including stroke and heart failure. It occurs when the electrical signals in the heart become disorganized, leading to ineffective contractions of the atria. Symptoms can vary widely; some people may experience palpitations, fatigue, or shortness of breath, while others may be asymptomatic.

Importance of Regular Monitoring
Given your history of AF and the medications you are currently taking (such as anticoagulants and beta-blockers), regular monitoring is crucial. This includes:
1. Heart Rate Monitoring: Keeping track of your heart rate can help you identify patterns or triggers. You mentioned fluctuations in your heart rate, which can be common in AF. It's essential to communicate these changes to your healthcare provider.

2. Anticoagulation Management: Since you are on anticoagulants, regular monitoring of your INR (International Normalized Ratio) is necessary to prevent thromboembolic events while minimizing the risk of bleeding.

3. Symptom Tracking: Documenting your symptoms, including episodes of palpitations or any changes in your overall health, can provide valuable information for your healthcare team.

Lifestyle Modifications
1. Exercise: While you have a running habit, it's essential to balance exercise with your body's signals. Overtraining can exacerbate AF symptoms. Consider a more moderate exercise regimen that includes walking, swimming, or yoga, which can help reduce stress and improve overall cardiovascular health.

2. Diet: A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can support your cardiovascular health. Omega-3 fatty acids, found in fish oil, may also help reduce inflammation and support heart health.

3. Stress Management: Given your experiences with anxiety and sleep disturbances, incorporating stress-reduction techniques such as mindfulness, meditation, or cognitive behavioral therapy can be beneficial. These practices can help manage anxiety, which may, in turn, help stabilize your heart rhythm.

Medical Management
1. Medication Adherence: Continue taking your prescribed medications as directed. If you experience side effects or have concerns about your medications, discuss them with your healthcare provider.

2. Regular Follow-ups: Schedule regular appointments with your cardiologist to monitor your AF and any other related conditions. This is particularly important if you are experiencing new or worsening symptoms.

3. Consideration for Procedures: If your AF is persistent and symptomatic despite medical management, your cardiologist may discuss options such as catheter ablation. This procedure aims to isolate the areas of the heart that are causing AF, potentially restoring a normal rhythm.

Multidisciplinary Approach
Given your complex medical history, a multidisciplinary approach may be beneficial. This could involve:
- Cardiology: For AF management and heart health.

- Ophthalmology: For your eye symptoms and any underlying conditions.

- Orthopedics: To address your chronic pain issues.

- Psychiatry or Psychology: For managing anxiety and sleep disturbances.

Conclusion
Managing atrial fibrillation, especially in the context of other health issues, requires a comprehensive and coordinated approach. Regular monitoring, lifestyle modifications, and appropriate medical management are key components. Don’t hesitate to seek second opinions or consult specialists as needed. Your health is a priority, and addressing each aspect of your well-being will help you achieve better outcomes. Always communicate openly with your healthcare team about your symptoms and concerns, as they can provide tailored advice and treatment options.

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