Will you be able to live a normal lifestyle?
Yes, although there may be some restrictions on some activities associated with certain medications that you may need to take. A healthy lifestyle and a healthy and balanced diet are important for everyone but it is especially important for people with heart problems, like atrial fibrillation. You should also limit your intake of alcohol and other stimulants such as strong tea or coffee or caffeine-based drinks. Clinical experience links stress to atrial fibrillation episodes whereas data from clinical trials is limited. It is plausible that steps to reduce daily stress (eg. yoga) may help with atrial fibrillation control. More detail is given in the sections below on alcohol, exercise, smoking, diet, sex, driving and travel and there are links to useful contacts for advice and support.
Do I have to stop drinking alcohol?
Alcohol consumption is associated with an increased risk of atrial fibrillation in a dose dependent fashion. Whilst moderate alcohol use should not usually cause problems in patients with atrial fibrillation, it is strongly recommended that excessive alcohol intake is avoided. If you experience that alcohol intake, even in low doses, triggers atrial fibrillation episodes it should generally be avoided. Large amounts of alcohol can cause atrial fibrillation and may affect stroke prevention with blood thinning treatment, particularly for patients who take vitamin K antagonists (such as warfarin, acenocoumarol etc). Excessive amounts of alcohol can increase the risk of bleeding among patients who take blood-thinning medication. You should tell your doctor honestly how much alcohol you drink daily.
Recommendations on alcohol intake vary by country but the World Health Organization recommends that people should not consume more than 2 standard units of alcohol a day. Click here to find out how many units there are in a drink.
You should also try to have at least 2-3 alcohol-free days per week.
Do I have to stop exercising or should I increase?
Moderate exercise is good for most people and helps to decrease overall risk of heart disease. Physical activity is important because it helps to regulate daily biological rhythms, improves sleep and mood and it is important for weight control. However, before starting any exercise program, you should consult with your doctor or another qualified healthcare professional to discuss what level of physical activity you plan to undertake.
As a rule of thumb moderate exercise is good for people with atrial fibrillation and should not raise your heart rate excessively. However, strenuous exercise should be avoided. It is known that atrial fibrillation risk is increased in endurance athletes such as long-distance runners or cyclists. So patients should be encouraged to do light to moderate exercise while avoiding excessive sports.
If you develop an episode of atrial fibrillation while exercising, you should stop, sit down and follow the recommendations of your doctor or seek healthcare advice if this is the first time you have experienced atrial fibrillation.
Do I have to stop smoking?
Yes, to stop smoking is important for your overall health so your doctor will strongly recommend that. Please seek advice from your general practitioner. In the case of atrial fibrillation, additional damage occurs because smoking makes the heart beat faster, and lowers the oxygen level in the blood.
What should I eat?
Generally we recommend that you eat a healthy and balanced diet and if you are overweight to lose weight. Your diet is particularly important if you are taking a particular type of blood-thinning medicine, a vitamin K antagonists. This is because there are foods, particularly green leafy vegetables (lettuce, chard, spinach), that contain lots of vitamin K that can affect the way these tablets work in the body, making them less effective. Read more about diet for patients who are taking warfarin/vitamin K antagonist.
If you are taking dietary supplements or herbal medicines such as St. John’s wort, ask your doctor about possible interactions with your medication, especially novel anticoagulation (NOACs). Routine intake of fish oil is not recommended to reduce atrial fibrillation episodes.
If you have high blood pressure it is advisable to eat foods low in salt (you can check this on food labels) and do not add salt when cooking or at the table. You can ask your doctor about possible replacement of usual salt with potassium salt (another type of salt that does not cause raise in blood pressure) or natural herbs.
Do I have to lose weight?
We know that about a third to half of adults in developed countries are overweight (body mass index – BMI > 25) or obese (BMI > 30). Obesity is closely linked to the risk to develop atrial fibrillation and increases the likelihood of AF recurrences after interventions such as ablation. Weight loss and lack of significant weight fluctuations improve atrial fibrillation control as well as outcomes after ablation.
Today’s scientific data strongly support the recommendation of weight loss for both prevention and management of atrial fibrillation. The primary target in obese patients is to lose 10% of body weight in the short-term.
Elevated blood pressure is a strong predictor of the development of atrial fibrillation. Treatment of hypertension is an important component of any atrial fibrillation management strategy particularly to reduce the risk of stroke or the likelihood of bleeding on oral anticoagulants.
Should I stop drinking coffee, tea and other caffeinated drinks?
This is a bit controversial. In the past some doctors recommended that people with atrial fibrillation should avoid drinking coffee completely. However there is no strong evidence to link caffeine intake with the risk of atrial fibrillation or its complications. Nevertheless, drinking too much caffeine could raise your blood pressure and caffeine also increases the heart rate (which might trigger atrial fibrillation). Therefore, it is advisable to limit keep your caffeine intake to a moderate level, for example 2-3 cups of coffee per day.
Should I avoid stress?
It is advisable for your general overall health to avoid stress as much as possible. There is some evidence that long-lasting and sudden stress can lead to episodes of atrial fibrillation.
Can I still have sex?
Yes, people who have experienced heart problems often worry about having sex. We know that people often reduce or stop having sex because they are scared it may bring on further heart problems. For example, some people believe that having sex could be risky and they think "I have to avoid it" or "There is a risk I could get too excited and it could kill me." Such thoughts led to unnecessary stress and anxiety about having sex. What we do know is that for most people with different sorts of heart problems, having sex is safe and indeed it is recommended by doctors. Think of it this way, for an average person, man or woman, having sex puts the same amount of work on the heart as a steady 20-minute walk. Having an orgasm is the same as walking up a flight of stairs. Exercise is good for the heart and sexual activity is just another form of exercise. So, regular sexual activity can actually be good for your heart.
- Sex is good for the heart
- Sex relieves stress.
- Sex boosts the immune system.
Is it safe for you to drive?
Yes, you can continue to drive. However, if you experience any episodes of dizziness or fainting you should not drive. You should tell your doctor so that they can check out what may be causing the dizziness and fainting (which could be related to your atrial fibrillation).
Can I travel?
Yes, in general there is no reason why you cannot travel (including flying) if you have atrial fibrillation but it is best to check with your doctor first. Comfortable travel is recommended and it is best to avoid extreme temperatures (heat and cold) and high altitudes. Before you make any holiday plans it is advisable that your atrial fibrillation is well controlled and stable. Before travelling you should make sure that you have all your medication with you and make sure that you do not run out of tablets while you are away, and take along a summary of your medical history.
Will I be able to get travel insurance if I have atrial fibrillation ?
Yes, the majority of patients with atrial fibrillation can get travel insurance. However, sometimes it may require a higher premium (cost more). Please seek advice from health insurance providers. Sometime it may be useful to contact several health insurance companies to find the best deal.
Where can I get more advice and support?
You can ask for advice and support from your doctor (general practitioner, cardiologist or hospital doctor) or you can contact one of the atrial fibrillation patient associations for more general advice and support.