Dr. John Day, Cardiologist

14 Reasons Why You Got AFib

So, why did you get atrial fibrillation? There are a lot of possible substrate causes—some of which you can control and some of which you cannot. Below is a list of the 14 most common reasons why our patients have developed AFib.

1. You Inherited the Wrong Gene

Some people inherit a genetic predisposition that makes AFib more likely. Up to a third of all people who have atrial fibrillation without another identified cause have a familial history of the condition.

At least fifteen different “potassium channel” mutations have been linked to AFib and at least seven “sodium channel” mutations are associated with AFib. Potassium and sodium ions are atoms that carry electric charges and thus are essential to the signaling system that tells parts of the heart to contract in rhythm. But a lot of non–ion-channel mutations have been linked to AFib, too. These include mutations in a protein-coding gene called NUP155; a gene linked to many heart disorders known as LMNA; a gene called NPPA that encodes a vital hormone created in the heart; and a set of genes known as GATA4, GATA5, and GATA6 that are key to the development of new heart tissue.

Those aren’t the only genes that have been linked to AFib, though—there are actually more than one hundred. Even if we were to create an exhaustive list, it would soon be outdated. Emerging research is revealing other “candidate genes” that may have links to AFib. For now, however, there isn’t a test that can scan all of the known and potential “AFib genes.”

While over-the-counter commercial DNA tests can scan for some, you’re really just scratching the surface with these products. What’s important to note is that while it can be very helpful to know whether you’ve inherited a genetic predisposition to AFib, there’s nothing we can do about the genes we were dealt.

However, it is equally important to understand that research conducted over the past few decades in the field of epigenetics has conclusively demonstrated that we do have the power to influence which genes are “expressed” and which genes are “silenced” based on the hundreds of little health decisions we make every day. Indeed, health outcomes among the individuals who have inherited any of these genes vary greatly based on factors that extend far beyond that inheritance.

2. You Have Another Heart Problem

If you were to round up all of the people with AFib in the world, you would find that somewhere close to half of them have also been diagnosed with another cardiovascular condition. Of these, the three most common culprits are heart failure, cardiac valve problems, and coronary artery disease.

3. You’ve Got a Few Years Under Your Belt

Margaret had been a picture of health for most of her life. She had followed a mostly plant-based diet free of fried, processed, and fast foods. She didn’t eat sugar. She’d never been overweight. She did aerobics every day at the gym and attended a yoga class three times a week. She practiced deep-breathing exercises whenever stress levels were getting too high. She slept well at night. She even volunteered as a crosswalk guard at the elementary school across the street from her house. And since no one in her family had ever been diagnosed with AFib, she was more than a little irritated when her doctor told her she had that arrhythmia.

But here’s the thing: Margaret was ninety-four years old. And the truth is that even if your genes are perfect and you do just about everything right, you can still get AFib as a result of age. Just as your skin will wrinkle over the years, the simple act of living life will put some wear and tear on your heart cells over time.

But there’s a big difference between being ninety-four and fifty-four—between AFib that results from natural aging and AFib that comes about due to premature aging. Most of the AFib cases we see are due to the latter kind of aging. And while there is nothing we can do to stop how many candles are on our birthday cakes—that’s chronological age—there is plenty we can do to slow the process of biological aging.

4. Your Blood Pressure Is Too High

Hypertension occurs when the force of a person’s blood against the walls of their arteries is high enough that it puts a person at risk of health problems. Within the heart, this means that, with every heartbeat, the organ is working harder to pump blood through more restrictive arteries. And all of this strain on the heart can cause its muscle to thicken and enlarge, disrupting electrical pathways and causing AFib. Indeed, of all of the factors that have been associated with atrial fibrillation, none may be stronger than hypertension. High blood pressure is the most commonly encountered condition in AFib patients, and research has shown that it nearly doubles the risk of developing atrial fibrillation.

Studies show that 90 percent of Americans are hypertensive by age fifty-five, so it’s little wonder why AFib is so common. It doesn’t have to be this way. Only 4 percent of the centenarians living in southern China’s famed “Longevity Village” of Bapan, the people we studied in our best-selling book The Longevity Plan, had high blood pressure. That finding is similar to studies of hunter-gatherers living in the Amazon rainforest or elsewhere in the world consistently showing a natural blood pressure of about 110/70 that doesn’t increase much, if any, with age.

Indeed, it appears from many studies that our genes are designed to keep our blood pressure naturally in this 110/70 range without medication as long as we don’t mess things up with our modern lifestyle. Low body weight, a mostly plant-based diet devoid of sugar and processed foods, daily physical exercise, rejuvenating sleep, and low perceived stress levels protected these people from the scourge of hypertension. It might seem like it’s impossible in a modern context to live as these people do, and that’s true. But the lessons we can draw from these elders are virtually endless, and your ability to apply these lessons to your own life are limited only by your imagination.

5. It’s One of these 11 Medications You Are On

6. Too Much Exercise

Over the years, we explained, we have noticed a particularly increased risk of atrial fibrillation in patients who regularly compete in ultra-endurance events, including running, biking, and cross-country skiing. Most of our patients are shocked when they learn that people who run marathons, competitively cycle, or do Ironman Triathlons are five times more likely to develop atrial fibrillation.

Also, it bears noting that while aggressively competing in endurance sports might put you at a greater risk of AFib, participation in these activities certainly does not guarantee you’ll get AFib. It is reassuring to note that recreational participation in endurance sports, even if it is a marathon or triathlon, doesn’t seem to increase this risk.

7. You’re Not Getting Enough Exercise

And regular exercise in general isn’t risky at all—in fact, it’s exceptionally protective. To put things into perspective, for every thousand patients we see with atrial fibrillation, perhaps one may be at risk for atrial fibrillation due to overexercising. The biggest problem, by far, is that most patients aren’t exercising enough. There is far greater risk from not exercising enough than from exercising too much. People who live sedentary lifestyles are at significant risk of AFib, not to mention all of the other health consequences of not getting enough exercise.

8. You’re Overweight

Nearly three-quarters of American men and nearly two-thirds of American women are overweight, if not obese. Today more than two billion people worldwide are overweight or obese In fact, the scientific data connecting weight and AFib are so compelling that many electrophysiologists (EPs) specializing in heart rhythm disorders feel that carrying extra weight is a primary cause of AFib.

Our research has shown that even a few extra pounds can make a big difference in a person’s AFib risk and how they respond to treatments. Other studies have shown that carrying too much weight is the main cause of an enlarged left atrium and premature heart aging—two critical components in the development of AFib.

Even if it’s only by a few extra pounds, being overweight can significantly raise your risk of AFib as we showed in one of our studies. And maybe it’s not just a few pounds. Perhaps you are obese. That word has a lot of negative baggage attached to it, which may be one of the reasons why people are reluctant to even step on the scale. Consciously or subconsciously, they simply don’t want to know. But when people do check, many are surprised to learn that they might indeed be obese, which substantially increases the risk of atrial fibrillation.

9. You Have Diabetes or Pre-Diabetes

Just about everyone knows that obesity puts people at risk of lots of other health challenges, especially diabetes. And it stands to reason that diabetes and obesity have been shown to be associated with an elevated risk of AFib, too.

Not only is your risk of AFib substantially increased with diabetes or pre-diabetes but your experience with that disease is likely to be a lot worse, as people with diabetes have worse AFib symptoms, report a lower quality of life, are more likely to spend time in a hospital, and experience higher mortality rates. There is good news in this regard, though: type 2 diabetes (also known as adult-onset diabetes, although children are increasingly affected) is usually reversible through weight control and processed carbohydrate reduction/elimination. That makes it manageable.

Manageable doesn’t mean “easy.” We live in a world that is constantly conspiring against us when it comes to the food choices that drive so many of our metabolic challenges. It’s also a world in which we’re constantly being told there are shortcuts to just about everything. But we’ll go to battle against those forces very soon. And we’ll do it together. It is something that even we, as cardiologists, have to battle every day. But, again, the important thing, at this moment, is to understand if this is one of the challenges you are facing. If so, the first step is to acknowledge that challenge, and accept its connection to AFib.

10. You’re Not Eating the Right Foods

Food is good medicine. A diet that respects what our bodies need to thrive might be the best way to prevent atrial fibrillation, or to beat it back once it starts.

A bad diet does the exact opposite. In fact, there isn’t much that is worse for you, when it comes to AFib, than eating foods loaded with sugar and other simple/processed carbohydrates. The Standard American Diet (the acronym “SAD” is tragically telling) has way more sugar than anyone needs, and it’s a veritable mass-delivery system for other simple carbs, which your body breaks down to create fast energy.

Most people know that if they’re trying to eat healthy, they should avoid sugar-filled foods like pastries, confections, and candies, along with sugary sodas. What many people fail to recognize is that many of the foods we often think of as “healthy” are also packed with sugar. Even “healthy natural sugars,” like honey, still cause our bodies to respond in roughly the same way: a sudden shockwave of sugar courses through our blood, and these bloodsugar fluctuations may cause cardiac scarring, which, over time, can cause atrial fibrillation.

Another bulk supplier of simple carbs in many people’s diets are refined grains like white flour and white rice, which have been stripped of most of their natural nutrients and fibers. The more processed a grain is, the faster it will be digested to sugar. That has the added consequence of making these foods less filling, so when you eat a white rice dish or a piece of white toast, you’re bound to be hungry again very soon. Sadly, even whole wheat bread isn’t much better. A single slice can spike your blood glucose higher than a Snickers bar.

The key is making sure that, to the greatest extent possible, the carbohydrates you’re getting are complex carbs, including fruits and especially vegetables. For now, though, it’s important to do a realistic assessment of your habits related to sugars and processed carbs. Anyone who isn’t actively avoiding foods with any and all types of added sugar, and limiting their processed or simple carbohydrate intake to those foods that are packed with complex carbohydrates (think vegetables and fruit), may be at an increased risk of AFib.

11. Your Thyroid Hormone Levels Are Off

Thyroxine is the main hormone created by the thyroid gland, and people suffering from hyperthyroidism have bodies that make way too much of it. That’s a big problem because thyroxine is a potent cardiac stimulant. In a way, having hyperthyroidism is like having a little energy-drink factory in your neck. So, you can see why people who have hyperthyroidism might experience increased heart rates, palpitations, and arrhythmias such as atrial fibrillation.

The scary thing is it doesn’t take full-blown hyperthyroidism to increase the risk of AFib. For example, our research showed that when people had thyroid hormone levels in the higher end of normal, they were 40 percent more likely to develop AFib.

Are you motivated to beat your AFib? If so, give my office in Salt Lake City, Utah a call to set up a consultation. Sorry, initial consultations all have to be in-person.

If you liked the photo with this article it was a picture I took this past week mountain biking with my teenage son overlooking Jupiter Bowl at the Park City Mountain Resort.