Prevalence of atrial fibrillation and an exercise prescription for it
Various findings of epidemiological studies worldwide indicate that the incidence, prevalence and AF associated mortality is progressively rising globally. The statistics about incidence of atrial fibrillation show that -
- it is more common among older adults, the median age for people with this form of arrhythmia is 74.6 years for women and 66.8 years for men.
- AF affects approximately 4 percent of the population over age 60, and 10 percent of the population over 80.
- Thirty-five percent of all AF patients will have a stroke at some point. AF-related strokes are 3 times as fatal as other strokes within the first 30 days.
- Death rates for women with AF are 2.5 times greater than for men.
- With the aging of baby boomers, AF is expected to increase to more than 10 million patients by 2050.
- AF is thought to be responsible for 88,000 deaths a year.
- Caucasians are much more prone to developing atrial fibrillation.
So, the above statistics serve to point to the fact that atrial fibrillation is fast assuming the status of a global epidemic.
Atrial fibrillation –
Atrial fibrillation (AF) is the most common type of arrhythmia, in which there is a problem with the rate or rhythm of the heart beat. During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm.
In the normal heart, an electrical signal spreads from the top of the heart to the bottom with each heartbeat. Each electrical signal begins in a group of cells, called the sinus node or sino-atrial (SA) node. The SA node is located in the right atrium. In a normal healthy adult heart at rest, the SA node sends an electrical signal to begin a heartbeat at the rate of 60 to 100 times a minute. From the SA node, the electrical signal travels through the right and left atria. It causes the atria to contract and pump blood into the ventricles. The electrical signal then moves down to a group of cells, called the atrio-ventricular (AV) node, located between the atria and the ventricles. Here, the signal slows down slightly to allow the ventricles to finish filling with blood. The electrical signal then leaves the AV node and travels to the ventricles. It causes the ventricles to contract and pump blood to the lungs and the rest of the body. From the right ventricle, blood is pumped to the lungs whereas from the left ventricle, it is pumped to the rest of the body. The ventricles then relax and the heartbeat process starts all over again in the SA node.
In atrial fibrillation, the heart's electrical signals don't begin in the SA node. Instead, they begin in another part of the atria or in the nearby pulmonary veins. The signals don't travel normally. They may spread throughout the atria in a rapid, disorganized way. This can cause the atria to fibrillate. Therefore, atria and ventricles no longer beat in a synchronized way. The ventricles may beat at a rate of 100 to 175 times a minute in contrast to the normal rate of 60 to 100 beats a minute. As a result, the blood isn’t pumped into the ventricles as well as it should be. The body may get rapid, small amounts of blood and occasional larger amounts of blood. The amount will depend on how much blood has flowed from the atria to the ventricles with each beat.
When an individual develops atrial fibrillation, he or she comes to avoid any physical activity. But the experts say that the physical activity is good for people having AF. Before beginning an exercise program, it is adviseable to consult a cardiologist, who may refer the individual to specialists for a rehabilitation program. Such specialists will plan a custom made exercise schedule for the person. Such special exercise schedule should include the following features –
- The person should avoid intense or long workouts because they are likely to cause symptoms of AF.
- The perosn should start walking slowly for 5 to 10 minutes daily. By adding a minute or two each week or so, the walking should be increased so that the unltimate goal of 30 minutes a day 5 days a week is reached.
- The person should learn how to take the heart rate form one's doctor. If the execrsie is intense and strenuous, there is a likelihood that the pulse will rise too high. If this happens, the person should slow down or stop the activity for some time before resuming it.
- If the exercise triggers pain, extreme breathlessness or exhaution, one should stop immediately.
- One should wear proper safety gears in order to avoid any injury while exercising because the person with AF may be having blood thinning medication.
- The person having AF should not lift so much weight that the person has to hold breath and grunt to go though the exercise. One should make sure that one lifts weight comfortably.
- Like anyone else concerned with exercise safety, the person with AF should take time to warm up and stretch before exercise and to cool down and stretch afterwards. Failing to stretch properly can put the person at risk for injury.
- If one with AF has to observe the fluid restrictions, one should be mindful of taking fluids while hydrating oneself. The person should not exceed the limits of fluid restrictions during exercise.
- Some medications used to treat AF can lower the blood pressure. So, it is adviseable to take frequent breaks for drinking water and paying attention to how one feels. If one feels dizzy or lightheaded during exercise, one should stop at once and cool off.
According to WHO data, 33.5 million people worldwide or 0.5% of the world population suffers from atrial fibrillation. Deaths linked to AF are rising around the world; more women with AF are dying in the developing world. The chance of developnig the onset of AF increases with age. The increase in its worldwide prevalence needs to evaluated from other causes including from obesity and hypertenson to air pollution.
A regular exercise progam will definitely help a person suffering from AF lead a better life by improving the general fitness level of the person. So, one can begin to start exercising under the supervision of experts along with its adequate management with medicines.