The Hidden Heart Problem That’s Claiming Men’s Lives Now

Working out is one of the healthiest things you can do for your heart, so imagine exercising intensely for a decade—like cycling at least 25 hours a week—and then finding out you have, of all things, a heart problem.

That’s what happened to Fabian Sanchis-Gomar, M.D., Ph.D. At 26, he was diagnosed with atrial fibrillation, or AFib. It’s a heart-rhythm disorder that increases your risk of a stroke or heart failure, and it’s killing nearly 40 percent more Americans (especially Black men) than it did just two decades ago.

For Dr. Sanchis-Gomar, it announced itself with “palpitations, dizziness, and shortness of breath,” he says. The diagnosis was frustrating, since he led a healthy life. Now he’s a researcher at Stanford University and the University of Valencia, seeking to fill a gap in modern medical knowledge. Currently, experts can’t pinpoint who will get AFib, or how dangerous it will be, and Dr. Sanchis-Gomar is furiously trying to identify genetic markers that can help change that. That’s critical because the earlier you catch it, the more treatment options you have, from meds and surgery to everyday lifestyle tweaks.

To understand how to prevent and detect it, you need to know how things should go in your heart, and what goes wrong. Normally, the heart’s electrical system coordinates the rate and rhythm of your heartbeats, which pump blood through the chambers. When someone has AFib, those circuits become faulty, says cardiologist Aseem Desai, M.D., author of Restart Your Heart: The Playbook for Thriving with AFib. “The chambers on the top quiver, beating rapidly and out of sync with the bottom two chambers.” You might have palpitations—anything from flutters to thumps—or become dizzy, tired, light-headed, or short of breath. Some guys feel fatigued; others feel nothing. AFib episodes can weaken the heart, which can be fatal. Researchers like Northwestern University’s Sadiya S. Khan, M.D., aren’t sure what’s causing the recent increase in deaths—they’re grasping at rising obesity rates and increased stress. But what is clear now is that the following precautions and preemptive practices can keep your risk for AFib down and help you detect it early.

How to Lower Your Risk of Afib Trouble

Listen to your heart

Today, many guys are spotting signs of AFib early thanks to heart-monitoring apps and alerts on smartwatches. They’ve been useful, since AFib is episodic and won’t show up on an EKG unless it’s happening right as the test is being taken. If you see an abnormal-pulse alert, call your doctor but don’t panic. Mayo Clinic research found that only about 15 percent of people who received this alert from an Apple Watch required treatment.

Check for sleep apnea

This is likely an underrecognized AFib risk factor in young and obese men, says Dr. Desai. The drop in oxygen when you stop breathing at night can trigger AFib episodes and alter the electrical system in your heart over time. “I’ve had patients who have failed every treatment for AFib that we have, and finally, when someone discovers they have sleep apnea and they’re treated, the AFib goes away,” he says.

Keep doing what your heart loves

What helps keep heart attacks away also helps chase AFib. That means: Keep your blood pressure and diabetes under control. Quit smoking if you haven’t already. Find a way to manage stress. Drop pounds if you need to—obesity may throw rhythms out of whack by enlarging your heart or causing fatty tissue to form around it that interferes with its complex circuitry.

Consider a different pour

The news that nonalcoholic beers are better than ever pleases more than your taste buds. Landmark research in the Journal of the American College of Cardiology suggests that every drink you consume per day increases your risk of an episode by about 8 percent. “Alcohol causes you to lose potassium and magnesium, two electrolytes in particular that are very important for your heart rhythm,” says Dr. Desai. Newer research strengthens the link between alcohol and AFib: This large study (nearly 108,000 people) suggested that one small alcoholic drink a day was linked to a 16 percent increase in the risk of AFib compared to people who drank nothing.

Exercise

There’s a U-shaped curve with AFib—people who don’t exercise are at higher risk, people who exercise moderately tend to have the lowest risk, and then there’s that troublesome issue of the highly trained athletes like Dr. Sanchis-Gomar who are also at higher risk for AFib. If you don’t exercise often, definitely aim to meet the American Heart Association’s recommendation of 150 minutes per week of moderate-intensity aerobic activity. If you are an endurance athlete, it can’t hurt to check in with a heart specialist and run through any risk factors, until research like Dr. Sanchis-Gomar’s comes up with a better way to identify AFib.

What to do if you’ve been diagnosed with Afib

“There used to be this notion that AFib was an incurable disease, and that there weren’t really a lot of treatment options out there,” says Dr. Desai. “That’s completely untrue.” Your options will depend on the frequency and severity of your AFib.

Common treatments include:

• Medications. Anti-arrhythmic drugs can be administered through a pill or IV to bring your heart’s rhythm back in order and/or prevent episodes. You may also get blood thinners to reduce your stroke risk.
• Cardioversion. This procedure, used for people with continuous AFib, is administered in a hospital and shocks your heart back into rhythm through electrodes placed on your chest. It’s really important to know about this: One review in the Journal of the American College of Cardiology suggests that Black and Hispanic people with AFib are less likely than white men to receive a cardioversion. If your doctor doesn’t mention this option, ask!
• Catheter ablation. Through a tiny tube, a doctor applies either extreme heat or cold to tiny areas of your heart, scarring locations that were making your electrical signals go haywire. Dr. Sanchis-Gomar had this at age 34, and at 42 he’s symptom-free.
• On the horizon: a quick fix for episodes. “Patients in the U. S. have no real options to have their hearts return to normal rhythm within a few minutes,” says Grace Colón, Ph.D., president and CEO of InCarda Therapeutics. The company is working on an oral inhalable version of an existing drug (flecainide) that can reach the heart quickly to stabilize its rhythm. InCarda estimates approval is a couple years away.