By Serge Tobias, M.D.

Contributing writer

Adults 65 years of age and older are at the highest risk for developing atrial fibrillation, also known as AFib.

The American Heart Association has found that about 9% of adults older than 65 have AFib. Atrial fibrillation is characterized by a fast, irregular heartbeat, or arrhythmia. Normally, the heart contracts in a regular rhythm, but with AFib, the upper chambers of the heart beat irregularly. The irregularity makes it difficult for the heart to pump blood to the rest of the body and can cause blood to collect in the heart and potentially form a clot.

Serge Tobias, M.D.

If a blood clot enters the bloodstream and lodges into the artery, it may lead to a stroke.

The American Heart Association says that atrial fibrillation can increase your risk of a stroke by 500% and double your chances of heart-related death. Other medical conditions common among older adults, such as high blood pressure, coronary artery disease, heart valve problems and heart failure, put someone at a greater risk of developing AFib.

The most common symptom of atrial fibrillation is an irregular heartbeat, but it presents itself differently between individuals. Per the National Council on Aging, “many older adults never experience, or fail to recognize, AFib warning signs.”

Common symptoms include:

  • Heart palpitations;
  • Dizziness or becoming light-headed;
  • Shortness of breath, even when resting;
  • Faintness or confusion; and
  • Chest pain.

Because of the increased risk of stroke in the older population with AFib, it is especially important for them to recognize the signs of a stroke. They can use the acronym B.E. F.A.S.T. to help them remember. It stands for:

  • Balance Lost: sudden loss of balance or coordination;
  • Eyes Blur: sudden trouble seeing or blurred vision in one or both eyes;
  • Facial Drooping: one side of the face droops or is numb;
  • Arm Weakness: sudden weakness or numbness of an arm or leg, especially on one side of the body;
  • Speech Difficulty: sudden confusion, trouble speaking or understanding speech; and
  • Time to Call 911: call 911 immediately (note the time the symptoms started).

To reduce your risk for atrial fibrillation, older adults should maintain a heart-healthy lifestyle by getting regular exercise, managing medical conditions, controlling cholesterol, quitting smoking and avoiding excessive amounts of alcohol and caffeine. Part of a heart-healthy lifestyle includes eating well-balanced meals that are low in salt, saturated fats, trans fats and cholesterol.

In a research trial published in “Circulation: Arrhythmia and Electrophysiology,” older adults with AFib had a significantly great decline in physical performance compared to those without the disease. The trial found that they tested worse on balance, grip strength and walking distance.

“The excess decline in physical performance in people with AFib was equivalent to an extra four years of aging,” the study said.

The potential connection between atrial fibrillation and walking ability stresses the importance of older adults remaining active and maintaining physical performance. Less mobility and a sedentary lifestyle can lead to poor health and additional medical issues.

When treating AFib, physicians will develop an individualized treatment plan for each patient’s unique needs, taking into consideration the older adult’s health, current medical diagnoses and fragility. Medications may be used to treat AFib, while some cases may require a procedure.

Resetting the heart’s rhythm using electrical cardioversion is one approach. The heart receives an electrical shock, while you’re under brief, mild anesthesia, which resets your heartbeat.

There are several other techniques, including implanting a pacemaker and surgery, depending on the severity.

If you think that you may have atrial fibrillation, talk to your doctor immediately. It is important to get your AFib under control as soon as possible.

Find a cardiologist associated with the MemorialCare Heart & Vascular Institute at Long Beach Medical Center by visiting

Serge Tobias, M.D., is medical director of electrophysiology at the MemorialCare Heart & Vascular Institute at Long Beach Medical Center.

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