Afib symptoms and signs don’t happen for everyone who has it. While Afib can occur without causing any symptoms, it can still be a hazardous health problem because it increases the risk of stroke by five times, heart failure by three times, and dementia and early death by two times.

Here are the five most common treatable drivers of atrial fibrillation:

• Unhealthy weight. The most common treatable cause for Afib and the one that research shows can be very powerful in lowering the risk of recurrent Afib. Research shows that if you are overweight, you can increase your chances of being free of Afib by up to 11 times, that’s 1,100 percent, by losing weight and getting more fit. Not to mention all the other benefits of improving your health.
• Poorly controlled blood pressure. Nationwide, less than ½ of people with high blood pressure have it controlled. This is unacceptable because we know exactly what works in lowering blood pressure. And getting your blood pressure controlled not only improves your Afib, but it also reduces your risk of stroke, heart attack, and kidney disease.
• Untreated sleep apnea. Experts estimate that 80% of people with sleep apnea don’t know it. Sleep apnea is a common “hidden” cause of Afib in my practice. If you snore or your partner says you quit breathing during sleep or you wake up feeling tired and unrested, talk to your doctor about being screened for sleep apnea.
• Sedentary lifestyle. Along with healthy weight loss, regular exercise and improved fitness are potent tools to lower your risk for recurrent Afib. However, there is a level of exercise that can actually increase your Afib.  Endurance level athletes that participate in triathlons and marathons are at increased risk for Afib, but for most of us, exercise is a powerful treatment for Afib.
• Excess alcohol consumption. We have long known that excess alcohol can cause Afib.  “Holiday Heart” is a phrase doctors sometimes use in reference to people who develop Afib over the holidays due to excess drinking. More recent research suggests that the optimal amount of alcohol for those with Afib maybe none. Even two drinks a day has been shown to increase the risk for Afib.

Treatment should start with reducing the most worrisome complication of Afib which is stroke. Those who suffer from Afib are five times more likely to experience a stroke. Afib causes nearly 20% of all strokes and when strokes occur due to Afib, they tend to be larger and have a higher death or permanent disability rate. Blood thinner medications are often recommended for high-risk patients with Afib to prevent stroke. 

Besides stroke prevention, the medical treatment of Afib can include irregular heartbeat medication and an atrial fibrillation procedure called ablation. Unfortunately, these treatments are often not as effective as we’d like them to be. A recent large research study of the treatment of Afib called the CABANA trial noted that only about 50% of those treated with ablation and about 30% treated with medications were free of Afib after 4 years. However, while the treatment statistics for Afib are not particularly encouraging, research shows a comprehensive approach to Afib that includes weight loss, improving fitness, optimizing blood pressure, cholesterol and blood sugar numbers, minimizing alcohol and addressing sleep issues can dramatically improve the chances of reversing Afib.

The CARDIO-FIT trial showed that people with Afib who were overweight who lost 10% of their body weight and improved their fitness, increased the likelihood of being free from Afib after four years from 34% to 94% compared to those who relied on just medications and ablations and did not lose weight or get more fit.