Managing your atrial fibrillation

Atrial fibrillation is a life-long condition that changes over time. In this article you will find tips and ideas to help you manage your AF, overcome challenges you might face with the condition and helpful hints to make your life easier.

Understanding your condition

You have an important role to play in the long-term management of your atrial fibrillation (AF). People who are most successful at managing their AF have a good understanding of their condition, treatment, and the skills needed to respond to their symptoms on a daily basis.

Managing your condition by taking your medication correctly and avoiding any known triggers will help control your symptoms. If you have paroxysmal AF avoiding triggers can reduce the number of episodes you have. 

It's also important that you know how to manage an AF episode when it occurs and understand when you need to seek medical help.

Knowing your individual risk of stroke

A major concern for many people living with AF is their increased risk of stroke. Your individual stroke risk depends on a number of factors, including the type of AF you have and other risk factors unrelated to AF. Together with your doctor or nurse, you can estimate your personal risk of stroke. This is likely to involve answering questions about other risk factors like your age, personal and family history of heart disease or stroke, and any other medical conditions you have.

Once you know your personal risk, you can make a decision about what you would like to do to lower your chance of having a stroke.

When thinking about the choices you can make to lower your risk of stroke, it is important to take into account your personal beliefs and concerns, and those of your family. You may like to take some family/whānau along to your appointment to help you talk through your options.

Questions you may like to ask your doctor include:

• “What are risks and benefits of the different options?”
• “What else could I consider?”
• “What changes can I make to my lifestyle to help lower my risk of stroke?”
• “What happens if I decide to do nothing?”

You can find out more about medication to reduce your risk of stroke on our diagnosis and treatment page.

Managing your atrial fibrillation symptoms

The symptoms that people experience with AF vary depending on the type of AF they have and how severe it is. You can read more about the symptoms on our AF condition page.

Your doctor will discuss a treatment plan to help you manage your symptoms.

When you see your doctor, she or he is likely to ask you a number of questions about the symptoms you are experiencing. Keeping a symptom record will help you answer these. You can use the following questions as a guide:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

A record like this will help you learn more about your condition. Sharing your symptom record with your healthcare team can also help determine the best treatment for you.

What you can do for your atrial fibrillation

Lifestyle changes can help reduce the amount of AF symptoms you experience. You can help yourself by:

• Cutting back on alcohol
• Reducing your caffeine intake
• Quitting smoking
• Taking regular exercise at a level you can manage comfortably i.e. can talk while doing the exercise
• Eating a healthy diet
• Weight loss if required 
• Reducing your blood pressure
• Taking your medications correctly and talking to your doctor before making any changes
• Identifying and treating sleep related breathing problems (sleep apnoea).

Managing your medication

Atrial fibrillation is a chronic condition and for many people this will mean taking medication for the rest of your life. It is normal to have concerns and anxieties about this, so it is important that you understand:

• What your medication does
• How to take your medication safely
• How long you will have to take it for
• Side effects to look out for and what to do if you develop side effects.

Make time to discuss with your doctor, nurse or pharmacist both the benefits and risks of your medication and why you need to take them. You can read more about AF medications on our diagnosis and treatment page.

Most people don't experience side effects from medication, but if you think you are experiencing them, contact your GP or healthcare provider. They may be able to change the dose or prescribe a different medication. Do not stop medications unless advised by your healthcare professional. There may be other choices of medication available so that you can be given something that suits you better.

In order to continue being symptom-free and to reduce your risk of stroke and other heart problems it is important that you continue taking any medication as prescribed. Talk to your doctor before stopping your medication. 

Top tips for managing your medication

1. Ask questions about your medications

We have a list of questions here – but you may have others. Write down the questions you want to ask and take them with you to your next health appointment.

• Why am I taking these pills?
• Will they be long-term or for a short time only?
• Which pills are essential for me to take regularly at the same time each day?
• What side effects can I expect and will these go away if I continue taking the pills? Are there any side effects that I should tell you about immediately if I experience them?
• Does any food interact with my medications: Is there anything I shouldn’t eat or drink?
• Are these pills meant to be taken regularly or just as needed?
• If I can use these pills when needed, is there a maximum number of tablets or frequency that I should use and when should I let you know if I am using more?
• Are there some pills that I can ‘play around’ with the dosing on? i.e. increase/decrease slowly depending on my symptoms. If yes, make sure the doctor writes down a guide (i.e. maximum number/dose, how often to reduce/increase).

2. Learn about your medications

Learn about your medications and keep a list of them with you. You can ask your doctor or pharmacist for a medication chart or card.

3. Stick to your prescription

Take your medication as prescribed by your doctor. Some medications are best taken at certain times of the day because of the way they work, the way your body responds to them or other medications you might be taking. However, if you are struggling with the times you take your medications, the timing can sometimes be changed. Talk to your doctor or pharmacist about your options.

4. Reminders to take your medication

If you have trouble remembering to take your medication, set a daily reminder on your mobile phone. You can also use a pill box (available from you pharmacy) or talk to your pharmacist about getting your medication put into a blister pack.

5. Don't catch up if you miss a dose

If you forget to take your tablets at your usual time don't try to catch up by taking extra tablets next time.

6. Plan ahead

Plan ahead so you don't run out - get your prescription filled in plenty of time.

7. Don’t stop taking your medications

Stopping medication suddenly can be dangerous - don’t stop taking your medications without consulting a doctor or nurse.

8. Learn about possible interactions

Tell your doctor or nurse about any herbal/natural health products or alternative/complementary therapies you take.

9. Store your medications in a safe place

Keep medications safe and out of reach of children.

10. Never share medications

Never give your medications to someone else.

11. Unused medicines

Return unused medicines to the pharmacy.

This information is courtesy of the Health Quality and Safety Commission.

Preparing for bad days

You may find that there are days when, for one reason or another, your symptoms feel worse. It helps to plan strategies ahead of time to deal with these symptoms and to help get you through the day.

Problem solving

Think about the things in your daily life that become difficult to manage on a bad day. What could you do to help solve the problem?

For example, when dealing with dizziness:

• Find somewhere to sit down and take slow breaths.
• Ask someone to get you some water (or always carry a small bottle of water with you).
• Take your time and rest for as long as you need to feel better

To help you deal with exhaustion:

• Have frozen meals prepared so that you can simply reheat them
• Ask family and friends to help you with chores or child care

To help you deal with atrial fibrillation symptoms:

• Sit down or lie down when you notice symptoms. Many episodes pass spontaneously
• You may like to try putting some headphones on and listening to music to settle you down

When to get medical help with atrial fibrillation?

Sometimes an AF episode will pass on its own, but in other cases you will need treatment to restore your heart beat to a normal rhythm. It can be difficult to know when to wait it out and when to seek medical help.

You should see your GP or go to an after-hours medical centre if your symptoms last for more than 24 hours, or sooner if you feel unwell. We advise that you get someone to drive you to the GP or medical centre.

When should I seek urgent help with atrial fibrillation?

Call for help immediately if you have symptoms of:

• Fainting or loss of consciousness
• Chest pain or angina
• Chest tightness, pressure, heaviness or pain in your chest, which may spread to your neck, jaw, shoulders, or arms
• Shortness of breath at rest
• Weakness, numbness or loss of movement of the face, arm or leg
• Speech that is slurred, jumbled, or lost
• Any visual disturbances.

Lowering your risk of heart disease

While atrial fibrillation is usually a life-long condition, there are choices you can make to lower your risk of further heart disease.

There are a number of factors that are known to increase your risk of heart disease. These are called risk factors. The more risk factors you have, the greater your chance of developing further heart disease. Some risk factors you can’t do anything about, including age, ethnicity, gender, personal or family history of heart attack or stroke. But there are other risk factors that you can change.

Learn how to manage your risk