Dr. John Day, Cardiologist

Does Atrial Fibrillation Have to Get Worse with Age?

AFib is a heart condition that, for many people, is little more than another inevitable consequence of aging, many doctors still tell their patients that there is nothing they could have done about it—and that there’s not much they can do now but make it “less bad.” They prescribe some drugs, or order up a procedure, and that is that. While AFib may be a warning sign that you are aging too fast, does atrial fibrillation have to get worse with age? And, is it possible to reverse aging to stop AFib?

Mary’s Experience with AFib

Mary 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: Mary was 94 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. Because 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.

What causes heart scarring (fibrosis)?

Before you can fight fibrosis, though, you’ve got to understand what it is. Fibrosis occurs naturally with aging—particularly after the age of 60. But natural scarring usually isn’t enough to sustain an AFib episode from a pulmonary vein- initiated premature contraction.

Excessive fibrosis, on the other hand, may disrupt how normal heart cells, called cardiomyocytes, look and move, just like how the kind of scarring we’re most familiar with—called dermal fibrosis—can make our scarred skin look and move differently than the rest of our skin. When we remember that every part of our heart is in constant movement, and all of those parts have been designed to work in harmony with the others, it becomes clear how this can become problematic.

Imagine, for instance, what would happen if you were to replace a valve in your home plumbing with one that was ever-so-slightly different in shape, or which moved a little differently than the valve that came before. Everything downstream of that valve would be impacted, right? The same thing is happening in the hearts of people with atrial fibrillation when cardiomyocytes are transformed from their ever-supple natural state to the tough and inflexible nature of scar tissue. Because in heart tissue, fibrosis causes another problem; it changes the ways in which electrical impulses move through our hearts.

Is AFib caused by premature aging?

Did you like the photo attached to this article? I took this picture on a recent run with my teenage daughter. It was taken with an iPhone using the night photo feature on a full moon as we were running on a ski trail in Park City, Utah. You can see the lights of Park City below.