Understanding Atrial Fibrillation in Brampton

Many people first hear the words “atrial fibrillation” in an unexpected setting. A home blood pressure monitor flashes an irregular heartbeat symbol. A smartwatch sends an alert. A doctor listening to the chest during a routine physical notices that the rhythm is uneven. Or someone arrives at an emergency department with palpitations, breathlessness or, in the most serious cases, a stroke.

Atrial fibrillation, often shortened to AFib or AF, is the most common sustained heart rhythm problem. It becomes more common with age, and it is closely linked to high blood pressure, heart disease and other conditions that many Brampton residents already live with. While AFib itself is often not immediately dangerous, it significantly increases the risk of stroke, and that is why understanding and treating it matters.

This post explains what AFib is, how it is commonly managed, and what you can do to take an active part in your care. The pharmacists at Pharmasave BramCentre, 14 - 7910 Hurontario Street, Brampton regularly help patients with AFib understand and organise their medications.

How a normal heartbeat is organised

Your heart has four chambers: two upper chambers called atria and two lower chambers called ventricles. A normal heartbeat begins with an electrical signal from a natural pacemaker in the right atrium. That signal spreads across the atria, causing them to contract and push blood into the ventricles. The signal then passes to the ventricles, which contract and pump blood to the lungs and the rest of the body.

This coordinated sequence gives a regular rhythm. At rest, a typical adult heart beats somewhere between 60 and 100 times per minute, though this varies from person to person.

What changes in atrial fibrillation

In AFib, the electrical activity in the atria becomes chaotic. Instead of a single organised signal, many disorganised signals fire at once. The atria quiver rather than contract effectively. Some of these signals reach the ventricles irregularly, so the heartbeat becomes irregular and is often fast.

AFib can be:

• Paroxysmal: episodes come and go, often stopping on their own
• Persistent: episodes last longer and may need treatment to restore a normal rhythm
• Long-standing or permanent: AFib is present most or all of the time

People can move between these types over time.

Why AFib raises stroke risk

When the atria quiver instead of contracting properly, blood can pool in parts of the upper chambers. Pooled blood is more likely to form clots. If a clot breaks loose, it can travel to the brain and block an artery, causing a stroke.

Strokes related to AFib can be severe. That is why stroke prevention is one of the most important parts of AFib care. Not everyone with AFib needs the same level of prevention; clinicians use tools that consider age, high blood pressure, diabetes, prior stroke, heart failure and vascular disease to estimate stroke risk and guide treatment decisions.

The Heart and Stroke Foundation has helpful patient information about AFib and its connection to stroke.

What AFib can feel like, or not feel like

Some people notice AFib right away. Others have no symptoms at all and find out only through a test. Common symptoms include:

• A fluttering, pounding or irregular heartbeat (palpitations)
• Shortness of breath, especially with activity
• Fatigue or reduced ability to exercise
• Dizziness or light-headedness
• Chest discomfort

Because symptoms vary so much, it is important not to rely on how you feel to judge whether AFib is under control. Seek emergency care (call 9-1-1) if you have chest pain, fainting, severe shortness of breath, or any signs of stroke such as face drooping, arm weakness or speech difficulty.

Smartwatches, home monitors and finding AFib early

More people are learning about possible AFib through consumer devices. Some smartwatches and fitness trackers can flag an irregular rhythm, and some home blood pressure monitors display an irregular heartbeat symbol. These features can be useful prompts, but they are not a diagnosis.

An alert can appear for reasons other than AFib, such as extra beats, movement during the reading or a poor sensor fit. On the other hand, a device that shows no alerts does not prove that your rhythm is normal. A diagnosis of AFib is usually confirmed with an electrocardiogram (ECG), sometimes with a longer-term monitor worn for a day or more.

If your device repeatedly flags an irregular rhythm, take a few practical steps:

• Note the dates and times of the alerts and how you felt.
• Save or screenshot any rhythm strips the device provides.
• Book an appointment with your family doctor or nurse practitioner to discuss them.
• Seek emergency care if an alert comes with chest pain, fainting, severe breathlessness or stroke symptoms.

Bringing organised information to your appointment makes it easier for your provider to decide what testing is needed. Your pharmacist can also help you understand whether any of your current medications or supplements could be affecting your heart rate.

How AFib is usually treated

AFib treatment generally focuses on three goals:

1. Preventing stroke, often with anticoagulant medications (blood thinners) for people whose stroke risk is high enough to justify them.
2. Controlling heart rate, using medications that slow the heart so it pumps more efficiently and symptoms improve.
3. Controlling rhythm in some people, using medications or procedures that aim to restore and maintain a normal rhythm.

Alongside these, managing related conditions, such as high blood pressure, sleep apnea, diabetes, excess weight and alcohol use, can reduce AFib episodes and improve overall heart health. Your cardiologist, family doctor or nurse practitioner will tailor the approach to you.

Blood thinners and AFib

Many people with AFib are prescribed an anticoagulant. Options include warfarin and direct oral anticoagulants such as apixaban, rivaroxaban, dabigatran and edoxaban. Each has its own dosing schedule and considerations.

Some important points:

• Take it exactly as prescribed. Missing doses can reduce protection against stroke.
• Do not stop it on your own, even if your heart rhythm returns to normal or you feel well.
• Check with the pharmacist before starting any new product, including pain relievers and natural health products.
• Know the signs of bleeding and when to seek help.

An earlier post in this series covers living with blood thinners in more detail. If you are not sure why you are on a particular blood thinner or whether it is still right for you, ask your prescriber.

Heart rate and rhythm medications

Rate-control medications commonly include beta blockers and certain calcium channel blockers, and sometimes digoxin. Rhythm-control medications are a separate group used in selected patients. Some of these medications interact with others, and some need periodic blood tests or heart monitoring.

Common questions to ask your pharmacist include:

• What is each medication for, and how will I know it is working?
• What side effects should I watch for?
• Do any of my medications interact with each other or with supplements?
• What should I do if I miss a dose?

A medication review at Pharmasave BramCentre is a good opportunity to go through all of these together.

Living well with AFib day to day

Many people with AFib live full, active lives. Some practical habits that may help include:

• Keeping blood pressure under control through medications and lifestyle
• Limiting alcohol, which can trigger episodes in some people
• Being mindful of caffeine and stimulants if you notice they affect you
• Staying active in ways your healthcare provider approves
• Asking about sleep apnea if you snore heavily or feel tired during the day
• Keeping a symptom diary that notes episodes, possible triggers and how long they last

If you monitor your blood pressure at home, be aware that some automatic monitors may be less accurate when the heart rhythm is irregular. Ask your healthcare provider how to interpret home readings if you have AFib.

Keeping a complex routine on track

AFib often comes with several medications taken at different times. Missing or doubling doses, especially of a blood thinner, can have serious consequences. Tools that help include:

• Compliance packs that organise medications by day and time
• Phone reminders linked to daily routines
• The prescription refill service to keep supply steady
• Home delivery for people who find it hard to get to the store

For older adults in multigenerational households, it helps when one family member understands the routine well enough to step in if needed.

Travel is a time when AFib routines often slip. A long trip to visit family abroad can mean changing time zones, unfamiliar meals, disrupted sleep and medications packed in the wrong bag. Before you go, ask your pharmacist how to adjust your dose timing across time zones, and make sure you have enough supply for the whole trip plus a few extra days in case of delays. Keep your blood thinner and rhythm medications in your carry-on in their original labelled containers, along with a written list of your medications and diagnoses. If you take warfarin, ask your prescriber how INR testing will be handled while you are away, and be aware that big changes in diet can affect your results.

Talk to Pharmasave BramCentre about AFib

Whether you have just been diagnosed or have lived with AFib for years, understanding your medications and keeping them on track is one of the most important things you can do. The pharmacists at Pharmasave BramCentre can help.

Drop by 14 - 7910 Hurontario Street, Brampton, ON L6Y 0P6, or phone (905) 497-5177. Our contact page lists other ways to reach us, and the booking page lets you request a time to go through your AFib medications with a pharmacist.

This article offers general information on atrial fibrillation. Decisions about your rhythm, stroke prevention and medications should be made with your own healthcare team.