#270 Will Atrial Fibrillation Kill You?

Will Atrial Fibrillation Kill You?

Heart problems are scary, and everyone sooner or later asks will atrial fibrillation kill you?  In this article, I’ll teach you what you need to do to add extra years to your life even if you have atrial fibrillation.

Jeff’s Story

“Will atrial fibrillation kill you?” Jeff asked me on the day we met. The interesting thing is that he was only 65 and had just finished a half marathon. Somehow he figured that if something was wrong with your heart, then death was imminent.

Other than his atrial fibrillation, Jeff was a picture of health. He ate right and took nature walks daily  to keep stress levels in check.  He was asleep every night by 10 pm and got at least seven hours of good sleep.

Jeff filled his days with a part-time consulting business and running. He and his wife Margie would travel the world looking for the next race to run. It was their way of exploring each new city.

Given how well he felt, he was in a state of shock when atrial fibrillation seemed to strike out of nowhere.  He loved his family, and he loved living.  He came to see me because he didn’t want atrial fibrillation to shorten his life.

Does atrial fibrillation shorten your life?

Based on our research, people with atrial fibrillation don’t live as long as those without atrial fibrillation. What we don’t know is whether this shorter life expectancy is from atrial fibrillation or the many other medical issues that often accompany atrial fibrillation.

For example, it is rare for me to see a patient, like Jeff, whose only medical issue is atrial fibrillation. In general, most of the people I see every day with atrial fibrillation have not optimized their lifestyle.  Most are overweight, aren’t exercising every day, and they eat the Standard American Diet (SAD).  In addition to a suboptimal lifestyle, they often have high blood pressure, sleep apnea, or other lifestyle-related conditions.

What we really don’t know is will atrial fibrillation still shorten your life even if you have optimized your lifestyle?  My personal opinion is that the longevity risks of atrial fibrillation are minimal provided you are doing everything else right.

Will keeping your heart in rhythm extend your life?

The simple answer to this question is it depends. For example, if keeping your heart in rhythm means a cardioversion and antiarrhythmic medications, then the answer is no.

Indeed, many studies comparing living out of rhythm versus taking an antiarrhythmic and having your heart shocked have shown no difference in survival. The reason for this is likely due to whatever survival benefit you may get from a normal heart rhythm is completely offset by the toxicities of the drugs used to get you there.

In contrast, our studies involving close to 40,000 patients have shown that a catheter ablation procedure to treat atrial fibrillation may extend your life. Once again, while normal rhythm likely gives you a longevity boost, the life extension benefit probably seen in our studies is also due to living a healthier lifestyle. Indeed, it is pretty difficult to get out of our clinic without also being encouraged to make healthier lifestyle choices.

Do your genes determine how long you live?

Most people assume that your genes determine how long you live.  While genes do play a role, it is much less than what people think.

For example, even with identical twins who share the same DNA, studies show that genes only account for 25% of how long they will live.  Thus, 75% of their life expectancy is determined by their daily lifestyle choices.

What do atrial fibrillation patients die from?

So what happens in the end?  How do people with atrial fibrillation die?

To answer this question, French researchers looked at the cause of death of every atrial fibrillation patient in a 2012 study. And what they found will likely surprise you.

Death from anything heart related ultimately claimed the lives of only a third of all French people with atrial fibrillation. However, fully two-thirds of the deaths occurred from other medical conditions.

The findings of this study come as a complete surprise to most physicians taking care of people with atrial fibrillation as well. Indeed, the real risk isn’t the atrial fibrillation but rather all of the other medical conditions that go along with atrial fibrillation.

The Top 5 Things That Shorten Your Life

Instead of thinking, “will atrial fibrillation kill you” the real focus should be on reversing lifestyle-related medical conditions.  These lifestyle-related medical conditions will rob you of far more years than atrial fibrillation.

For example, studies show that smoking, weighing more than you should, not exercising, stress, and diabetes all take approximately ten years off your life. Even if you live the rest of your life in atrial fibrillation, reversing just one of these five conditions will give you back far more years than atrial fibrillation might take. Indeed, when put in proper perspective, the risk of atrial fibrillation can’t even begin to compare to the premature death risk of smoking, weighing more than you should, not exercising, stress, or diabetes.

Jeff’s Story Revisited

Because Jeff had already optimized his health, there wasn’t anything we could do to reverse his atrial fibrillation naturally.  Interestingly, his 23andMe home genetic test showed that the cause of his atrial fibrillation was probably genetic.

As the atrial fibrillation drugs slowed his running times, Jeff was looking for a permanent solution to his atrial fibrillation that didn’t involve taking medications.  He was ready for an ablation.

While it ultimately took two ablation procedures, his atrial fibrillation is totally gone now.  And to ensure he never goes out of rhythm again, he tracks his heart rate and EKG with the new Apple Watch Kardiaband.

Practical Tips

If your goal is a long and healthy life, focus on optimizing your overall health rather than worrying about atrial fibrillation. In the big picture, atrial fibrillation can’t even come close to affecting your lifespan the way healthy living can.  And if you can optimize your overall health, then there is a good chance your atrial fibrillation may go away on its own without drugs or procedures.

Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.

  1. Hello, I have atrial fibrillation but it does not cause me a lot of problems ,but I think it might be starting to give me shortness of breath when exercising. I am aged over 70 but I am fairly fit. I refused to have a pacemaker fitted on first Diagnosis. A different Cardiologist said this was the best decision. Do you have any observations on this, I would be grateful for them. Best regards, D. P. Gleeson (Mr)

    • Shortness of breath with exercising is a common atrial fibrillation symptom. And it makes sense…when people are in atrial fibrillation the upper chambers of the heart aren’t pumping at all. So you lose 20-30% of the heart’s peak capacity. At rest you won’t notice this drop off but with exercise it becomes very noticeable.

      Pacemakers serve an entirely different purpose. Pacemakers don’t fix atrial fibrillation. All pacemakers do is speed up a slow heart rate.

      With your new shortness of breath it is time to get in touch with your cardiologist again. Hope this helps!


    • Hi Vee,

      23andMe won’t show you if atrial fibrillation is genetic or not. In fact, unless they have changed their practice, they probably won’t tell you anything about atrial fibrillation due to FDA constraints.

      In my case, I had to release my 23andMe data to Promethease. And then for $5, promethease sent me a 300+ page report on all of my findings. Among these findings were some atrial fibrillation SNPs or “genes.”

      At the time I did my study, there was still little that was known about the genetic causes of atrial fibrillation. I suspect you can get more information today…

      Hope this helps!


  2. Interesting article. I have AFIB but am otherwise healthy (try to watch what I eat; exercise regularly; etc.). I’ve been unable to stay in rhythm naturally but for the last 5 years have been on 100 mg of Flecanaide twice a day which keeps me in rhythm. As far as I can tell, I don’t have any side effects, but I do worry about hidden toxicities.

    I’ve been reading Dr. Mandrola’s blog regularly and he frequently talks about the hazards of ablation and all the things that can go wrong, which has scared me away from trying it. But after reading this, maybe it’s time to get an ablation?

    I suspect my AFib may be genetic as well, as I’ve had several other family members with it.

    • Hi Diane,

      Thanks for reading and commenting! Dr. Mandrola has an excellent blog and he is a good friend of mine.

      Yes, there can be complications with ablation or for that matter any procedure. However, I also believe that the procedure, through extensive experience and refining, can be optimized to minimize any possible complication.

      Despite this, the question of whether or not to have an ablation is a personal one. Not everyone’s answer is the same…

      Hope this helps!