Is Ageing Changing Your Heart Rhythm? What To Know About Atrial Fibrillation

As we grow older, changes in our body are a natural part of life. But when it comes to the heart, some changes deserve closer attention. One condition that becomes more common with age is atrial fibrillation, or AFib, an irregular heart rhythm that can sometimes go unnoticed.

AFib is increasingly relevant as populations age and people live longer. India is estimated to have nearly 7.9 million people living with AFib, making it one of the countries with the highest burden of the condition globally. While age is an important factor, AFib is not an inevitable part of growing older. Understanding what it is, what can increase the risk and which symptoms should not be overlooked can help people pay closer attention to their heart health.

Here are five things to know about AFib and ageing:

1. First, what exactly is AFib?

The heart normally beats in a regular, coordinated rhythm. In atrial fibrillation, the upper chambers of the heart, called the atria, experience chaotic electrical activity. Instead of contracting normally. Not all of these impulses reach the lower chambers, so the heartbeat you feel at the pulse is much lower than this, but it is often irregular and can be faster than the normal resting rate of 60-100 beats per minute.

During AFib, the atria can experience electrical impulses at around 450-600 beats per minute, compared with a normal resting heart rate of around 60-100 beats per minute.

AFib can affect people at different ages, but it becomes more common as we grow older.

2. Why does AFib become more common with age?

Ageing is one of the main factors associated with AFib. Over time, the heart muscle can become stiffer, the atria can stretch and enlarge, and scar-like tissue, known as fibrosis, can gradually build up. These changes can disrupt the normal electrical signals that keep the heartbeat steady, making an irregular rhythm more likely.

The prevalence of AFib also increases with age. Around 3-4% of people at the age of 60 may develop AFib, while the proportion rises to around 8% by the age of 80.

With India's population ageing and people living longer, understanding age-related changes in heart rhythm is becoming increasingly important.

3. Could AFib symptoms be mistaken for normal ageing?

AFib does not look the same in everyone. Some people may experience palpitations, fatigue, breathlessness, or instability while walking, while others may have no noticeable symptoms at all.

For older adults, symptoms such as tiredness or breathlessness may sometimes be attributed to age or other health conditions. This can make AFib easy to overlook.

That can be particularly concerning because AFib is associated with a 3-5 times higher risk of stroke compared with a normal heart rhythm. In some people, a stroke or heart failure may even be the first indication that they have AFib.

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4. Age isn't the only factor

Getting older does not automatically mean developing AFib. Other conditions can also increase the likelihood of the condition, including diabetes, long-term hypertension, coronary artery disease, pulmonary disease and sleep apnea.

Lifestyle factors can also influence AFib risk, making it important to avoid binge alcohol consumption and smoking or tobacco use.

There can also be a genetic predisposition. AFib may occur even in people who do not have these commonly recognised risk factors, suggesting that genetics may play a role in some cases.

This is why heart health needs to be looked at more broadly than age alone.

5. When should you get your heart rhythm checked?

An unusual or persistent change in heart rhythm should not simply be dismissed as a part of getting older. AFib can be detected through an electrocardiogram (ECG), while doctors may recommend additional monitoring depending on the individual.

This can include a Holter monitor or extended loop recorder, which can monitor heart rhythm for several days. In selected patients, an insertable loop recorder can monitor the heart rhythm for 3-5 years, helping identify episodes that may otherwise go unnoticed.

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Alongside being aware of symptoms, maintaining heart health becomes increasingly important with age. Regular exercise and yoga, as well as keeping track of blood pressure, diabetes and dyslipidaemia (cholesterol level), can help people stay more aware of their cardiovascular health.

Ageing is a natural process, but understanding the changes that can occur in the heart can help people recognise when something may need medical attention. For AFib, recognising unusual symptoms and getting them evaluated can be an important first step towards appropriate management.

(By Dr. Bharat Shivdasani, Honorary Consultant Interventional Cardiologist, Jaslok, Saifee and Breach Candy Hospital, Mumbai)

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