Atrial fibrillation

Psychological effects
As well as physical symptoms, atrial fibrillation (AF) can have unexpected psychological effects on people’s lives, bringing about unwelcome changes and a sense of disruption. Jeni, in her early forties, talked of ‘feeling like a little old granny’ after her diagnosis; others spoke of anxiety, panic attacks and depression. Roger, in his early sixties, felt he was living in a body twenty years older as his symptoms worsened. He felt that AF was controlling his life. Although she has now come to terms with her condition, Nuala was anxious, lonely and in ‘total despair’ when first diagnosed. She described having a heart condition as a form of grieving and felt she was ‘the only one is the world with this’. Gail, a GP, found the sudden changes in her body difficult and felt like a failure.

The uncertain and irregular nature of AF episodes can make people feel out of control and unable to plan their life with confidence. George Y was adamant that he ‘does not want AF’. He found the unpredictability and lack of control very unnerving and felt anxious that his AF would take over eventually. Carin spoke of living in fear of having an episode of AF, saying that while people dismissed AF as a benign condition, she felt as if she was ‘in a trap’. Geoff spoke of how he had become afraid to go too far from home and from his local A&E department. To try to improve the quality of their lives, some people tried antidepressants or cognitive behavioural therapies. Facing the future
AF is a chronic condition which can be successfully treated. But it needs to be managed to ensure people enjoy a good quality of life and minimise their risk of stroke. We asked people to consider the impact that AF might have on their lives in the future. Some talked about practical concerns including the effect of AF on travelling, getting travel insurance, holding a driving licence, and caring for a child with special needs (for more see ‘Impact of atrial fibrillation on relationships and leisure time’). Others reflected on uncertainty, their risk of stroke, heart attack or heart failure, and their fears of a loss of independence or a shortened lifespan as a result of their heart ‘beating so fast at times’. Some people, treated successfully for AF, expressed concern that it may return or that the technology may fail. Ginny was aware that ‘ablations might not last forever’ and that she might need to go through another operation at a later stage. Eileen feared her pacemaker may ‘pack up’ and send her into heart failure. (For more see ‘Medical procedures and interventions for atrial fibrillation’). Some people talked about what the future might hold in terms of scientific breakthroughs. Eileen wondered whether she had ‘jumped the gun’ in having an AV node ablation given possible future advances in science. Roger expressed hope that through new medication or procedures he may be able to ‘get better control, get more of my life back from what I’ve got at the moment, because it is debilitating and it’s a strain, it’s a struggle, when you can’t do what you want to do.’ Marianne was impressed by the number of consultants working on a cure for AF, but doubts it will happen ‘in my lifetime’. Most people, however, resolved to be positive, not worry about AF too much, and just get on with life. For some it was a ‘wake-up call’ to reassess their lives. Nuala felt grateful that AF had given her ‘an opportunity to look at my lifestyle and what I’ve been doing’. Others talked about taking things easy and not getting stressed, trying to lead as healthy a lifestyle as possible, hoping for the best, and ‘carrying on as usual’. Accepting that ‘life is a lottery’, Ginny just wanted to get on with the rest of her life; Dot is on warfarin and felt she had ‘nothing to worry about’. For her, AF was preferable to ‘something much, much nastier’.