How an active lifestyle can reduce the risk of developing AF

The heart condition atrial fibrillation (AF) has been proven by leading cardiology researchers to affect those who are less active, in comparison to those who are.

Leading cardiology and electrophysiologist Professor Dhiraj Gupta tells us all about his recent findings into AF treatment and reversal and those by researchers from the National Yang Ming Chiao Tung University in Taiwan, which was presented at the European Cardiology Congress (ECC) in August.

What is atrial fibrillation and what can happen if it’s left untreated?   

Atrial fibrillation is an irregular heartbeat. It can lead to blood clots and stroke if it’s left untreated. It happens when the electrical impulses that triggers the heart muscle contractions chaotically misfire.

The normal pumping action in the atria, the two upper chambers of the heart, is disrupted, and results in an erratic and rapid heart rate of up to 300 beats a minute or more. Other than unusual palpitations or heartbeat, often there are no warning signs.

What do recent statistics reveal about AF and fitness?

The researchers in Taiwan tracked 15,450 people over a decade, who at the beginning of the study didn’t have atrial fibrillation. Results showed that the fittest participants, mostly in their fifties when the trial began were significantly less likely to develop the condition.

The heart is being put under stress just by virtue of working harder to maintain a body that’s heavier than it should be, when someone is sedentary and overweight. It presents a huge physical strain for the heart, which can result in AF.

What are the risk factors involved in AF?

Some unavoidable risk factors are age and genetics. Lifestyle, based on the evidence presented, has a role to play. If you do things which increase general pressure in the heart such as smoking, under-exercising or gaining excess weight and eating too much salt, all of these things can stretch the heart’s atrium chambers and increase risk.  

How can you reduce the risk of developing AF?

Lifestyle changes

Smartwatches can help to keep tabs on your heart rhythm and is like a portable EGC monitor. Devices like the Apple Watch can be set up to flag heart rate abnormalities and records heart rhythm data during sleep, which can be analysed for signs of atrial fibrillation. It’s important you don’t become obsessed with results. Once a week is enough and the test takes about 30 second to complete.

Reduce alcohol intake    

Caffeine isn’t a cause of AF. However, alcohol is among the biggest stressors for AF. According to a 14-year study by the European Heart Journal, just one small glass of wine a day, a single shot of spirits or small bottle of beer is enough to raise the risk of the condition by 16 per cent, compared with non-drinkers. If I see someone in their fifties or younger with atrial fibrillation with AF, I’m more than certain that alcohol is likely to be involved. It’s advisable to reduce intake based on these findings.

Avoid intense exercise

Extreme exercise can also cause AF. Regular exercise reduces the resistance thorough which the heart has to pump, and that’s a good thing. However, an excess of anything isn’t good.

A recent study published in the Clinical Journal of Sport Medicine, which analysed 924 athletes mostly in their fifties, found middle-aged and older ultra-runners, cyclists, swimmers and triathletes who developed AF were at greater risk of stroke than the general population.

Apparently super fit people who take good care of their bodies may also be placing a toll on the heart that predisposes them to AF, even though it’s unfair. Their hearts are responding to being stressed beyond its means, and the body wasn’t designed to run hundreds of miles a week. It can take its toll.

Is it possible for AF to be reversed?

If it’s spotted early, AF is reversible. I recently presented an updated review of evidence after a separate study he had published in the European Heart Journal three years ago. It showed that weight loss in overweight people with AF slows progression, and in some cases reverses it.

How is AF treated?

AF gets worse the longer people have it. The more the heart gets used to it, the worse it becomes. By getting people to spend as much time as possible in a normal rhythm, the aim is to break that spiral.

The main route in the past for people who don’t respond to lifestyle changes was through tablets including beta blockers or amiodarone. This was to control heart rate and rhythm, although they aren’t without side effects.

Catheter ablation, a keyhole surgery technique in which thin, flexible electrical catheters are inserted via small tubes into the veins near the groin and used to burn heart tissue, has emerged over the last decade as the most effective treatment.

It creates an electrical insulation barrier in the heart, which prevents the faulty electrical signals from causing arrhythmia. It’s extremely effective and only take about 90 minutes to perform.

Professor Gupta is available for consultation. To arrange one with him, arrange one via his Top Doctors profile.