More people than ever before have atrial fibrillation (A-fib), an irregular heart rate that occurs when the upper chambers of the heart beat chaotically and out of coordination with the lower chambers. A-fib can increase the risk of both stroke and heart failure.
Fortunately, you can reduce or even prevent A-fib episodes (arrhythmias) by following an anti-A-fib plan. The following strategies can help about 50 percent of people remain symptom-free even without taking medication.
There is no universal cause of atrial fibrillation, but if there’s one characteristic that people with A-fib share more than any other, it is that they are overweight. Don’t be discouraged if you have a lot to lose. In one study, my colleague and I showed that losing just 3 percent of a person’s body weight, which could be as little as five pounds, increased the long-term chances of putting A-fib into remission. If you are going to take the necessary steps to get your weight in check, however, you have to be 100 percent committed. Back-and-forth weight changes could be an additional A-fib risk factor.
A healthy diet is unquestionably important for losing weight and keeping it off. But “healthy” doesn’t mean “low calorie.” Diets that are based on counting calories don’t work for most people. People can lose weight using almost any diet that regulates caloric intake, but that weight rarely stays off. So while these diets might be able to offer our hearts a temporary reprieve—and that’s a start—it’s not the secret to putting our metabolism into balance. Instead, look at the quality of your diet. Minimize or avoid added sugar and flour, eat lots of vegetables, and avoid processed and fast foods.
Next, weigh yourself every day. I’ve rarely seen a patient who hasn’t successfully lost weight or kept it off by simply weighing themselves regularly. Why does this work so well? After seeing a bit of weight gain, people may exercise a little bit more the next day, or they may watch what they are eating more carefully.
I’ve also had many A-fib patients who have successfully maintained their weight loss through the use of a food journal. The key is accountability.
People who need to lose more than 100 pounds may want to consider weight-loss surgery. In a study of Swedish patients who were overweight, those who had bariatric surgery were 29 percent less likely to develop A-fib. I’ve even seen cases—quite a few, in fact— in which A-fib has gone into complete remission with bariatric surgery alone.
Another way to maintain a healthy weight and a healthy heart is to exercise. Do something every day, even if it’s just a little. Your heart’s atria are responsible for 20 to 30 percent of total cardiac performance, so A-fib can reduce your exercise capacity. The goal should be to do something that makes you breathe heavily and sweat a bit—if only for a few minutes each day. Research has shown that just a little strenuous exercise each day, like a five- or ten-minute jog around the block, can confer many of the same health benefits as much longer periods of vigorous exercise in terms of longevity and reduced risk of heart disease. Furthermore, several small bursts throughout the day can build up for more benefits.
Exercise also promotes sleep. Outdoor exercise is especially beneficial because you’re exposed to natural light, which is vital to a strong sleep-wake cycle.
Just one night of bad sleep can triple your risk of an A-fib attack the next day, but that’s just the beginning. Sleeplessness can also make it harder to manage your weight, control your stress, and have the energy to exercise—all key elements in an A-fib management plan.
Many people who struggle with sleeping well can benefit from the following practices. First, set a bedtime and a wake time with at least seven hours in between and stick to it. Don’t stay up late and sleep in on weekends. Don’t hit the snooze button. Sleep in a clean, quiet, and cool room with plenty of fresh air and no electronic devices. Limit caffeine to 100 milligrams per day and avoid it within six hours of bedtime.
Avoid alcohol. While it may make you feel sleepy, it actually disrupts your sleep cycle, which decreases overall sleep quality and duration. What you do right now to improve your health will set you up for future success.
In fact, unless you are feeling dehydrated, avoid drinking anything after dinner, and use the restroom before you go to bed. If you have trouble falling asleep, take a 104˚ F bath or shower and read something that relaxes you before bed. Choose print or a non-backlit e-reader to avoid sleep-disruptive blue light.
By practicing what’s called good sleep hygiene, you’ll feel more than rested. You’ll likely be less hungry too. Studies show that people who sleep well eat about 522 fewer calories than people who are sleep-deprived.
It turns out that work stress really is bad for you. A study found that people who experienced negative job-related stress were 37 percent more likely to develop A-fib. Women were at particular risk with a 79 percent increased risk.
Stress comes from other sources, too, of course. Nowadays, news and the internet may top the list. What’s the most common emotion you associate with consuming news content? If you said “anger,” you should know that researchers have found that the likelihood of an A-fib episode goes up nearly six times following an experience with anger. By contrast, according to the same study, on the days you are feeling happy, your risk of an A-fib episode is decreased by 85 percent. To lower media-induced stress, cut back your time consuming it. You may even want to try a “social media fast,” where you cut out all social media.
To combine the benefits of both exercise and stress reduction, consider yoga. Dhanunjaya Lakkireddy, MD, a cardiologist from the University of Kansas Medical Center, has demonstrated that yoga can reduce a person’s A-fib burden by 24 percent. It also lowers blood pressure, anxiety, and depression among patients with A-fib. If stretches and poses aren’t for you, consider other forms of mindful engagement like meditation, tai chi, prayer, or nature walks. The key is turning distress into eustress, a moderate state of stress that you can interpret as being beneficial.
For some people, early and aggressive lifestyle changes are enough to halt A-fib, but others may want to consider ablation. In a fascinating study, researchers showed that by eliminating A-fib with an ablation, nonablated, diseased areas of the heart were able to heal themselves over the following two years. This is nothing to rush into lightly but, for many people, it’s a necessary treatment that should be discussed with a physician sooner rather than later. Ablation is not a “cure” for atrial fibrillation—at least not by itself. You’ll still need to optimize your lifestyle to keep A-fib in check in the long term.
Every case of A-fib is different, just like every person who experiences it. Some people can manage it just with the steps outlined above. Others may follow this plan and still need some additional medications—but the odds are that taking these steps will likely lower the number and dosages of those drugs. That, in turn, will lower medication side effects, including things like the weight gain, low energy, and poor sleep that contributed to A-fib from the start.
Making wholesale lifestyle changes can feel daunting, so you might want to tackle one thing at a time. You’ll soon see that each step can make the others easier.
