Afib Statistics

**An estimated 2.7–6.1 million people in the United States have AFib. With the aging of the U.S. population, this number is expected to increase.**

I've seen this statistic fairly often. I'm guessing the 4 million range is trying to account for those who have it, but haven't been caught on an EKG (or are not even aware they have it)?

I think it's probably mainly due to there being different estimates by various sources. Hard to estimate this stuff because afib isn't a reportable diagnosis. You walk into see your doc, he does an ECG, diagnoses you with afib, hands you a couple of prescriptions and out the door you go. Nobody at the CDC hears about it, and Medicare only knows about it if you're over 65, so there just aren't good stats available.

I'm amazed at the number of people I know that have it afib. Also many who are diagnosed have no idea how to tell if they are in afib. I saw a friend at a party. He mentioned he had afib and was looking at getting a Watchman device (never had an ablation). I asked him if he was in afib at that moment. He replied no. I asked if I could feel his pulse. Sure enough he was in afib. I have a sense that the numbers may be higher than shown. I randomly got into a conversation with a commuter train passenger from Portland OR. He'd had 3 failed ablation and a full MAZE!

When I went to the ER after my all night episode and had the EKG that showed Afib, the PA on duty said "They'll send you home and tell you to take an aspirin a day." She acted like Afib was no big deal. She even said if you had to have a heart thing, you would choose Afib. However, the cardiologist came in and said that he wanted to be admitted and checked out since they had no records on my heart.

So....after tests, I was given the BP meds and Eliquis prescriptions.

So, even though the med professionals don't seem to treat it that seriously, I would imagine that if you tried to get insurance, it would be considered a pre-existing condition.

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GeorgeN
I'm amazed at the number of people I know that have it afib. Also many who are diagnosed have no idea how to tell if they are in afib. I saw a friend at a party. He mentioned he had afib and was looking at getting a Watchman device (never had an ablation). I asked him if he was in afib at that moment. He replied no. I asked if I could feel his pulse. Sure enough he was in afib. I have a sense that the numbers may be higher than shown. I randomly got into a conversation with a commuter train passenger from Portland OR. He'd had 3 failed ablation and a full MAZE!

I've met a couple of people who have it. My next door neighbor said he has had one episode 6 years ago. He was never prescribed anything for it though and has not had another episode.

One other I know, who is a little older than me, has it. When I found out I had it, he agreed with me how scary it was. At that time, he had not had an episode in about 6 months. However, since then, he has apparently developed permanent Afib, because his doctor said he would have it from now on. I haven't talked with him personally, but his wife said he is doing great, and doesn't even think about it. I figured they must have given him something (rate control drug maybe) because when I talked with him before, he was very symptomatic with his episodes.

This thread made me think of a question I have.

When a doctor and patient decide to leave the patient in "permanent" Afib, doesn't that cause heart damage (failure? ) since your heart is not working efficiently?

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katesshadow
This thread made me think of a question I have.

When a doctor and patient decide to leave the patient in "permanent" Afib, doesn't that cause heart damage (failure? ) since your heart is not working efficiently?

If your rate is well controlled, then no, heart failure should not happen. There are people who live with permanent afib for decades. Medicating with anticoagulation and rate control drugs while leaving the person in afib is not an uncommon option. It was an option my EP offered me during my 2.5 month episode at the beginning of my afib "career." I declined and suggested my plan "B" which he fortunately accepted and I've been pretty much following since (detraining, electrolyte repletion & PIP flec when I go out of rhythm infrequently).

When I first showed up here, nearly 15 years ago, there was a saying that "afib is the hemorrhoids of cardiology." Many don't take it seriously as you've noted.

Not if the rate is controlled. Under 100 bpm and anticoagulated will pretty much minimize any risk from AF. It’s a patient’s choice whether or not to live in permanent AF. I personally wouldn’t make it. I’d insist on durable restoration of NSR. But at the end of the day it is always personal choice. Just make sure the patient is the one making the choice and not the physician. Get second or even third opinions.

I'm frequently wondering if the fact that endurance athletes seem more prone to afib doen't come from the fact that they are usually more symptomatic, hence being diagnosed with afib; when sedentary people tend to be less symptomatic and, due to this, less easily diagnosed with afib?
I know there are stats showing that many afibbers have been endurance athletes, but those stats always start from people having been diagnosed with afib. They don't mind people having afib without knowing (and not yet diagnosed).
My father (now gone) didn't know he had afib. He didn't feel it. He had two strokes before being diagnosed.
My mother is 90 and she's afibber for years. She lives with it (rate control and AC).
Both were active, but didn't practise sport.
I'm a cyclist. My first afib episode (not diagnosed) was enough for me to feel bad from the first seconds. The 2nd episode saw me going to the ER (and being diagnosed).

So, if you were to compare the heart of someone who lived with permanent Afib for 20 years, with rate control and anticoagulants, with a person with a "normal" heart, what would be the difference?

Is it mainly a quality of life issue.....how it makes you feel?

I know my friends husband said his first episodes were uncomfortable and scary. Now he's in permanent Afib and saying no big deal. 😳😳

I was lightheaded and breathless when I finally went to the ER. I don't know what my rate was and this was after about 8 or so hours of Afib. I'm sure anxiety was playing a part too.

Probably the size of the atria (enlarged) and the amount of fibrosis (scarring) in them. 20 years of LSPAF will create a lot of electrical remodeling.

I could imagine that over time a patient could become used to the rhythm and not be so symptomatic. It is a quality of life issue.

I think we all react similarly to initial AF episodes. I was also dizzy and short of breath the first few times. After a few months I stopped reacting to it at all. I once documented AF at an average ventricular rate of 55 without any betas at all. So the adrenaline response was gone at that point. I knew the episodes would stop so I just waited. I even biked and ran. My wife got mad at me once because I dusted her on the bike in AF. Now there's support for you!

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wolfpack
Probably the size of the atria (enlarged) and the amount of fibrosis (scarring) in them. 20 years of LSPAF will create a lot of electrical remodeling.

I could imagine that over time a patient could become used to the rhythm and not be so symptomatic. It is a quality of life issue.

I think we all react similarly to initial AF episodes. I was also dizzy and short of breath the first few times. After a few months I stopped reacting to it at all. I once documented AF at an average ventricular rate of 55 without any betas at all. So the adrenaline response was gone at that point. I knew the episodes would stop so I just waited. I even biked and ran. My wife got mad at me once because I dusted her on the bike in AF. Now there's support for you!

I've read numerous times that Afib itself is not dangerous, but the fear factor is still there for me. Others have also said that after the first few episodes, you become accustomed to it (still not pleasant though). I still dread (if and when) the next one.

Rate control drugs barely put a dent in my standard 150 BPM afb routine. I was dizzy, out of breath and ultimately had ejection fraction ('EF') of 25% and heart failure diagnosis, by the way at 40 yrs. old.

No F'in way you could keep me in afib permanently without calling it what it would be, a slow early death sentence sitting on the couch doing nothing.

Cardiologists that say ablations don't work and doom people to a life of AFIB really get me steamed. Go see Dr. Natale and put all these hypothetical questions to rest.

I sit here today drug free with an EF of 65% living life again. This from being a young man about to apply for disability and give up on life. Don't become accustomed to anything you can fix.

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Fibrillator
Rate control drugs barely put a dent in my standard 150 BPM afb routine. I was dizzy, out of breath and ultimately had ejection fraction ('EF') of 25% and heart failure diagnosis, by the way at 40 yrs. old.

No F'in way you could keep me in afib permanently without calling it what it would be, a slow early death sentence sitting on the couch doing nothing.

Cardiologists that say ablations don't work and doom people to a life of AFIB really get me steamed. Go see Dr. Natale and put all these hypothetical questions to rest.

I sit here today drug free with an EF of 65% living life again. This from being a young man about to apply for disability and give up on life. Don't become accustomed to anything you can fix.

That's really great. Happy for you. Gives you a new lease on life I bet!

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Fibrillator
Rate control drugs barely put a dent in my standard 150 BPM afb routine.

That sounds like flutter. 150 is a really common flutter rate and flutter is often resistant to rate control drugs. Flutter and afib often go hand in hand. Mine did. The afib would trigger the flutter and vice versa.

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katesshadow
I've read numerous times that Afib itself is not dangerous, but the fear factor is still there for me.

That’s normal.

I went into AF 3 years post ablation out of the blue while running. Weirdest thing I’d ever experienced. It wasn’t the least bit uncomfortable and I didn’t even stop running. So that kind of killed the fear factor for me. I still get ectopics from time to time while exercising. I live in the US Southeast and it is humid as you know what. We call it swamp-*ss. I just run through them and they go away. I replenish electrolytes religiously.

This AF thing has a lot to do with mind over body. Hang in there.

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wolfpack

I've read numerous times that Afib itself is not dangerous, but the fear factor is still there for me.

That’s normal.

I went into AF 3 years post ablation out of the blue while running. Weirdest thing I’d ever experienced. It wasn’t the least bit uncomfortable and I didn’t even stop running. So that kind of killed the fear factor for me. I still get ectopics from time to time while exercising. I live in the US Southeast and it is humid as you know what. We call it swamp-*ss. I just run through them and they go away. I replenish electrolytes religiously.

This AF thing has a lot to do with mind over body. Hang in there.

Thanks. I wish i wasn't so sensitive to every little feeilng I have......

Hot here too. (Georgia) 96 degrees yesterday and it's still May !

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Carey

Rate control drugs barely put a dent in my standard 150 BPM afb routine.

That sounds like flutter. 150 is a really common flutter rate and flutter is often resistant to rate control drugs. Flutter and afib often go hand in hand. Mine did. The afib would trigger the flutter and vice versa.

Yes I was often in Flutter too. Was when I went on the table with Natale as a matter of fact. My Flutter was being triggered in the coronary sinus. All fixed now, if I knew now what I knew when I wasted my time for 2.5 yrs and 3 ablations with the local "good" guy. Well.... so I will be tough love guy around here and tell people where they need to go (Hint, Natale). There's enough compassion already ;-)

Why do all of these docs do Ablations when they can't fix the problem, surely if Natalie can do it why isn't there doctors studying his methods so whatever they are doing wrong can be changed.

Liz

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Elizabeth
Why do all of these docs do Ablations when they can't fix the problem, surely if Natalie can do it why isn't there doctors studying his methods so whatever they are doing wrong can be changed.

That's a very good question. Natale does tons of training and a huge number of EPs have learned to use his methods, but he can't train all of them. Plus there are egos out there. I've heard of more than one EP bad mouthing him, calling him a cowboy, overly aggressive, etc, and when you get down to it all they're really doing is displaying their fragile egos. He can do what they can't, so they bad mouth him.

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Elizabeth
Why do all of these docs do Ablations when they can't fix the problem, surely if Natalie can do it why isn't there doctors studying his methods so whatever they are doing wrong can be changed.

Liz

Liz

My understanding is that it’s not a question of which methods they are using. Ablation is an extremely difficult procedure, and it takes many hundreds of them before an EP becomes even moderately proficient. So doctors at the beginning of their learning curve are eager to do as many as possible, which means they are practising on their patients, and have low success rates. The EPs who have done thousands are really good at it so have high success rates.

In addition to all that, some EPs have a special gift, or a feel for what they are doing, and become maestros with the catheters. A bit like some musicians - the great guitarist, Segovia, said of his pupil John Williams, "God has laid a finger on his brow". Same thing with Dr Natale, Prof. Haïssaguerre and a few others.

Gill

It’s also money. Ablations are cash cows.

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Elizabeth
Why do all of these docs do Ablations when they can't fix the problem, surely if Natalie can do it why isn't there doctors studying his methods so whatever they are doing wrong can be changed.

Liz

I was at the top hospital a teaching University in Chicago with 3 failed ablations.

I now know the guy who did me wrong had never ablated a unique persistent left super vena cava like I have. Hell they never even told me about it until after my 2nd one and I honestly believe he missed in the initial MRI and abaltion. I now know one of the residents did some of the work. They did not even go after the PLSVC in the 1st two ablations which is so wrong. By the time he did the 3rd he was copying some burns some other guys had done in a case he read near as I can tell. Most of those burns could not even be found by Dr. Natale a few months later!

When I asked him at one point in this whole 2 year process is there anything this guy Natale in Texas is doing you can't the answer was a flat out "No". I

Which in hindsight is laughable, they both wear the title of Electrophysiologist but are not even in the same league. 1st guy did not know much beyond a basic PV isolation (and to think he was training the residents!) oh and by the time I got to Natale one of those was conducting again, this after 3 ablations, so he couln't even do that. He wanted to do a 4th or suggest open heart surgery!

So ego, they don't know what they don't know, institutional protocal and procedure, EGO, EGO, EGO and other factors. And as noted before some people just have a gift for some things that can never be taught in all sorts of disciplines. Medicine and specifically ablations logically are no different then.



Edited 1 time(s). Last edit at 05/30/2019 09:37PM by Fibrillator.

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Liz

Why do all of these docs do Ablations when they can't fix the problem, surely if Natalie can do it why isn't there doctors studying his methods so whatever they are doing wrong can be changed.

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Gill
My understanding is that it’s not a question of which methods they are using. Ablation is an extremely difficult procedure, and it takes many hundreds of them before an EP becomes even moderately proficient. So doctors at the beginning of their learning curve are eager to do as many as possible, which means they are practising on their patients, and have low success rates. The EPs who have done thousands are really good at it so have high success rates.

In addition to all that, some EPs have a special gift, or a feel for what they are doing, and become maestros with the catheters. A bit like some musicians - the great guitarist, Segovia, said of his pupil John Williams, "God has laid a finger on his brow". Same thing with Dr Natale, Prof. Haïssaguerre and a few others.

Gill

I concur with Jill. Experience counts and some docs truly have a "gift." A number of years ago, Shannon accompanied a friend from Hawaii when his friend was being ablated by Natale. Shannon told me watching him was truly watching poetry in motion. As to some of the more advanced or complex techniques that Natale does, he instructs his fellows (EP's in training) in these techniques, but many fellowship programs don't teach these techniques because the teaching EP's don't know them. Both Natale and the Bordeaux team have been very good about trying to teach others. In fact, when Nalate was the medical director for the Center for Atrial Fibrillation and the section head of pacing and electrophysiology at the Cleveland Clinic, he was teaching others on his own time. The CEO declined to renew his contract around Oct 2007 (reportedly because he didn't like Natale teaching). That's when the folks in Austin created a purpose-built facility for him. Ego as Fibrillator says!



Edited 1 time(s). Last edit at 05/30/2019 09:35PM by GeorgeN.

my 97 year old father is in permanent afib……..converted on its own from PAF to permanent when hit with the airbag in a car accident.

He feels fine and is only on a blood thinner (coumadin).

I saw one particular EP here in the UK 18 months ago and when I mentioned Natale he said, and I quote “hah; that cowboy!’ I was not impressed to say the least.



Edited 2 time(s). Last edit at 05/31/2019 03:29PM by mwcf.

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mwcf
I saw one particular EP here in the UK 18 months ago and when I mentioned Natale he said, and I quote “hah; that cowboy!’ I was not impressed to say the least.

That cowboy took me from no hope and three failed ablations and heart failure to full on normal life again. If he's a cowboy YEEHAAAAWWWW!