Living with atrial fibrillation

Atrial fibrillation - also known as AF or AFib - is not usually life threatening - however, it can sometimes cause uncomfortable symptoms and, when untreated, it can increase your chance of having a stroke by 4 to 5 times.1,2

Your doctor may prescribe you an anticoagulant, sometimes known as a blood thinner to help reduce your risk of an AF-related stroke.2,3 However, anticoagulants may also cause you to bruise and bleed more easily, and any bleeding, if it happens, may take longer to stop.2,4

Although this may be worrying, it does not mean that you need to stop doing the things that you love. Understanding what to do if you have a bleed while on an anticoagulant and how you can prevent injury in your everyday life, may be helpful. With some lifestyle modifications, you may also reduce your risk of having AF symptoms or a stroke.5

Watch a short animation on how to live with AF

These are some of the things that you can do to help you live with AF

Although you may still be able to do most of things you love, you will need to take extra care. This is especially important if the activity involves using sharp objects.6 You should give some extra thought around how you can protect yourself from cuts and abrasions before you do an activity that can cause bleeding. Some examples of things you can do to prevent injury are:6

  • Use a softer toothbrush to protect gums from bleeding
  • Use a finger guard when chopping your food with a knife
  • Wear gloves when gardening

If you do cut yourself do not be alarmed – stay calm and treat the wound normally. However, if you cannot get the bleeding to stop, or if you are worried that something is wrong, please seek medical help immediatly.2

There are some changes to your lifestyle that you might consider making to help reduce your AF symptoms, as well as your risk of stroke. These include (among others):

  • Having a healthy, well-balanced diet - a diet rich in fish, olive oil, vegetables, fruits, nuts, beans and whole grains, and low in sugar and processed foods (known as the Mediterranean diet)2,5
  • If you are taking warfarin, please speak with your healthcare provider before changing your usual diet suddenly2,6
  • Staying within a healthy weight range - a healthy weight may reduce your risk of AF and/or stroke, as well as other medical conditions, such as diabetes, high blood pressure, and high cholesterol5
  • Quitting smoking- smoking can double your risk of AF symptoms but quitting can decrease your risk by about one third2,5
  • Cutting down on alcohol and caffeinated drinks - excessive consumption of alcohol or stimulants with caffeine, especially the artificial ones found in over-the-counter and prescription medications, can trigger your AF symptoms2,5
  • Exercising regularly - regular physical activity is usually good for your heart and reduces your risk of AF symptoms2,5 – ask your healthcare provider what type of exercises are appropriate for you
  • Treating any other medical conditions that you may have, such as diabetes, high blood pressure, or high cholesterol - these conditions may increase your risk of AF symptoms2,5

There are some things you should keep in mind while are on anticoagulant:

  • Remember to carry your anticoagulation alert card wherever you go2
  • Always tell everyone in your healthcare team – including your dentist, pharmacist, and nurse – that you are taking an anticoagulant2
  • Always ask your healthcare provider whether you can take other medicines - including prescription medicines, over the counter medications, and herbal supplements - with your anticoagulant,2 as these medications might make you more likely to bleed or make your anticoagulant less effective at reducing your risk of a stroke6,7

For instance, you can still:

  • Work
  • Go on holidays
  • Exercise
  • Have sex
  • Garden
  • Swim

… and much more!

If you are worried about doing your favourite activities because of AF or the medications that you are taking, there are a few steps that may be helpful:

  • Write down the activities / hobbies / events that are important for you to enjoy your life
  • Bring this sheet (with your answers) to your next doctor’s appointment, and ask your doctor what changes, if any, you’ll need to make to keep doing these things that you love

Explaining AF to your friends and family can sometimes be difficult

When your family and friends learn that you have AF, they may have a lot of questions about your condition and your medication, and how they can support you. These questions usually come from a place of love and concern for your health, but being asked lots of questions can be stressful – especially if you do not know the answers.

Here are some facts about AF that you can share with your family and friends to help reassure them:

  • Our heartbeats are created by electrical signals, which cause most peoples’ hearts to beat at even and consistent intervals8
  • However, your heart beats to a different rhythm, because the electrical signals do not work quite properly – your AF makes the electrical signals fire off from different places of your heart in a chaotic way8
  • Because of this chaotic signalling, you might sometimes feel tired or out of breath.1,8 This is not your fault, it is just the AF.
  • Although AF itself is not usually life-threatening, you might have more heart-related complications – importantly, AF may increase your risk of a stroke1,8
  • Because of your increased risk of AF-related stroke, your doctor may prescribe you an anticoagulant (also known as a blood thinner) to help reduce this risk1-3

But reassure your family and friends that your doctor will help you to manage your AF and come up with a treatment plan that suits your needs.

  • Although an anticoagulant is an important part of your treatment plan (if prescribed), you may be more at risk of a bleed while you are on an anticoagulant – these can be minor bleeds or more severe bleeds2-4
  • Because of this, your family and friends may sometimes notice small things like blood on your gums after brushing your teeth or more intense bruising4
  • While they may feel overprotective of you, let them know that small increases in bleeding are normal and that you can continue to do the things you love
  • However – if they are concerned that the bleeding is worrisome or not stopping, they should ensure you to get medical attention immediately2

If your family or friends ever need to speak to a medical professional (doctor, nurse, pharmacist, or dentist) on your behalf, it is very important that they tell them that you have AF and are on an anticoagulant2

Remind everyone that AF does not mean that you cannot continue to live your life as you have done so far.

Although your friends and family might be worried for you, it does not mean that you cannot continue to live your life as you have done before. Remind everyone that AF can be managed with the help of your doctor1 and let them know they can support you by ensuring you take your medication.2

1. NHS. Overview – anticoagulant medications. May 2018. Available at https://www.nhs.uk/conditions/anticoagulants/. Last accessed November 2020.

2. Stroke Association. Atrial fibrillation (AF) and stroke. May 2019. Available at https://www.stroke.org.uk/sites/default/files/media-root/f26_atrial_fibrillation_and_stroke_v4_web.pdf. Last accessed November 2020.

3. NHS. Atrial fibrillation, treatment. Available at https://www.nhs.uk/conditions/atrial-fibrillation/treatment/. Last accessed May 2021.

4. NHS. Side effects – anticoagulant medications. May 2018. Available at https://www.nhs.uk/conditions/anticoagulants/side-effects/. Last accessed November 2020.

5. Sabzwari SRA et al. Cureus 2018; 10: e2682.

6. NHS. Considerations – anticoagulant medications. May 2018. Available at https://www.nhs.uk/conditions/anticoagulants/considerations/. Last accessed November 2020.

7. NHS. Warfarin. April 2019. Available at https://www.nhs.uk/medicines/warfarin/. Last accessed November 2020.

8. Mayo Clinic. Atrial fibrillation. June 2019. Available at https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624. Last accessed November 2020.

PP-ELI-HKG-0655 JUN 2021