In someone with coronary artery disease, does every episode of atrial fibrillation  mean damage to the heart?

Damage to cardiac tissue can result from an episode of atrial fibrillation in a person with coronary artery disease.

Not all people with CAD experience A-fib, and not all people who have periods of atrial fibrillation have coronary heart disease.

Arial fibrillation is a rhythm disorder that increases the risk of blood clots that can lead to a heart attack or stroke.

This arrhythmia is characterized by a sudden increase in heart rate — but it’s not a steady rate. It jumps all over the place.

Atrial fibrillation and coronary artery disease can exist in the same patient, and there are times when an event of atrial fibrillation results in a mild elevation of troponin, the protein enzyme that leaks from the heart muscle—indicating that damage was sustained.

Does every incidence of A-fib, in someone with coronary artery disease, necessarily cause damage to the heart?

“Most episodes of AF do not cause the troponin to be elevated,” says Dr. Simon Dixon, chairman of cardiovascular medicine for Beaumont Health System in Michigan.

“This depends a lot on the heart rate during episodes as well as other factors such as blood count and the extent of coronary disease.”

Thus, if someone with heart disease has several A-fib episodes per week, this does not necessarily mean that the patient’s heart gets damaged (as revealed by elevated troponin) every time.

“Atrial fibrillation can occur in episodes (paroxysms) or be present all the time (permanent),” says Dr. Dixon. “Most patients with AF do not sustain muscle damage unless the heart rate becomes quite uncontrolled, or there are other medical factors such as fever, low blood oxygen level or low blood count.”

Dr. Dixon specializes in the treatment of acute and chronic coronary artery disease, with research focusing on pioneering treatments to save heart muscle in patients having heart attacks.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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