Imagine your heart as an orchestra, keeping perfect time. Now imagine one section — the strings, maybe — starts playing out of sync. The music becomes chaotic. That’s what happens in atrial fibrillation, or AFib — the most common type of irregular heart rhythm.
Instead of beating in a steady rhythm, the upper chambers of the heart (the atria) quiver, or fibrillate. This causes the heart to beat irregularly and often too fast. Some people feel fluttering, fatigue, or dizziness; others have no symptoms at all. But even when silent, AFib can be dangerous, dramatically increasing the risk of stroke and heart failure.
AFib is on the rise, affecting millions of people worldwide and increasingly straining healthcare systems. As this condition becomes more common, the demand for specialized care is rapidly growing. However, managing AFib isn’t just about acute interventions or procedures; it also requires ongoing, chronic management to reduce complications, improve outcomes, and enhance quality of life. That’s where remote care management is playing an increasingly vital role, offering patients consistent monitoring, personalized support, and proactive adjustments to care plans outside the clinic walls.
In the column to follow, I will cover the fundamentals of AFib, explore why it’s becoming so widespread, examine how this is contributing to growing demand for electrophysiology specialists, and highlight why remote care has become an essential component of effective long-term management of the condition.
What Causes AFib, and Why Is It on the Rise?
AFib doesn’t happen without reason. The most common risk factor is age. As people get older, the electrical system of the heart becomes more vulnerable to disruption. Conditions like high blood pressure, obesity, diabetes, heart valve disease, lung disease, kidney disease, and sleep apnea further increase the risk of developing AFib. These ailments can strain the heart or alter its chemistry, triggering irregular rhythms. In addition, high blood pressure, coronary artery disease, heart valve problems, or past heart attacks can damage the heart and disrupt its electrical pathways.
Lifestyle choices matter, too. Heavy alcohol or caffeine use, smoking, poor sleep, lack of exercise, or taking stimulants (even some cold medicines) all make the heart work harder and irregularly, which can provoke an AFib episode in susceptible people. In fact, drinking a lot of wine or binge alcohol often triggers new-onset AFib.
People born with heart defects or those who have had heart surgery likewise run higher AFib risk. Family history matters as well — AFib can run in families, implying a genetic component.
In short, anything that stresses the heart’s rhythm — whether it’s age-related wear, chronic illness, or certain habits — can increase AFib risk. Interestingly, some otherwise healthy people get “lone AFib” without an obvious cause, but most patients have one or more of the risk factors above.
What’s most alarming is how common AFib is becoming. It’s estimated that over 37 million people worldwide are living with AFib, a number projected to rise. The United States alone is seeing nearly 6 million cases, and that number could double over the next two decades.
Why the surge? Longer life expectancies, rising obesity and hypertension rates, and improved detection tools — like smartwatches that flag irregular heartbeats — have made AFib easier to diagnose and more common to develop. Today’s wearable devices and routine heart-monitoring find many episodes of AFib that would once have gone unnoticed. Consumers wearing smartwatches or patches often discover “silent” AFib by getting a notification of an irregular pulse. In sum, aging societies plus more heart-disease risk factors and better screening mean we’re diagnosing AFib in ever more people.
Meet the Heart’s Electrician: The Electrophysiologist
Managing AFib isn’t just about treating symptoms. It's about getting to the root of the electrical issue in the heart. That’s where electrophysiologists, or EPs, come in.
EPs are cardiologists with advanced training in diagnosing and treating heart rhythm disorders. Using tools like electrophysiology studies and catheter ablations, EPs can find the exact area of the heart that’s misfiring and often fix it — sometimes permanently.
These doctors can run detailed tests (like an electrophysiology study) to pinpoint where the irregular signals in the heart come from. For example, in AFib, EPs often find extra electrical foci in the atria (commonly near the pulmonary veins) that trigger the arrhythmia. Once the culprit area is identified, an EP has specialized tools to treat it. They may perform a catheter ablation (burning or freezing tiny spots) to block the abnormal signal, or implant devices (like pacemakers or defibrillators) if needed.
As AFib cases rise, so does the demand for these specialists. Health systems are experiencing a growing shortage, leading to longer wait times for care. Training new EPs takes years, and many institutions are now expanding fellowship programs to meet future demand.
Why Chronic Management for AFib Matters
AFib is rarely “cured” overnight. Many patients live with it long-term, requiring ongoing care to prevent complications — especially stroke. Since the atria don’t contract normally in AFib, blood can pool and form clots. If a clot travels to the brain, it causes a stroke. In fact, AFib increases stroke risk fivefold.
To counter this, doctors routinely prescribe blood-thinning medications (anticoagulants) for patients with AFib. These drugs dramatically cut the chance of a clot and stroke. To reduce that risk, doctors often prescribe anticoagulants (blood thinners) and medications to control heart rate or rhythm. Lifestyle changes like weight loss, better sleep, and reduced alcohol use can also reduce AFib episodes.
Beyond stroke, keeping AFib controlled helps the heart in other ways. A fast, irregular beat over time can weaken the heart muscle or lead to heart failure. Managing AFib with medications (to slow the rate or restore normal rhythm) and addressing underlying conditions (like controlling blood pressure or treating sleep apnea) helps the heart pump more efficiently.
Lifestyle changes are also part of chronic care: losing weight, exercising, and avoiding alcohol and smoking can reduce AFib episodes. In short, sticking with a doctor’s treatment plan — daily meds, regular check-ups and heart-healthy habits — can keep AFib “under control.” This long-term approach prevents complications (strokes, heart damage) and keeps patients out of emergency rooms.
The Role of Remote Care for Managing AFib
In a post-pandemic world, remote care, including remote patient monitoring (RPM), is revolutionizing how we treat AFib. Today many patients use wearable devices or remote monitors to track their heart rhythm at home. For instance, smartwatches and patches can continuously monitor pulse and detect irregular patterns. In one recent study, implantable monitors and consumer wearables were used to send real-time alerts when a patient went into AFib. These alerts can be set up to notify the patient or their doctor automatically.
Telehealth visits have become a lifeline, allowing patients to discuss symptoms, adjust medications, or review heart data without leaving home. Cardiology experts note that telehealth can improve access and efficiency of care from home.
In practice, this means a patient might have a video visit to discuss heart rate logs or receive medication refills without traveling to the clinic. Combining these tools, doctors can catch AFib episodes earlier and adjust treatment sooner. For example, a patient’s Apple Watch might flag an AFib episode one morning, leading to a telehealth consult that same day rather than waiting weeks. Overall, remote monitoring and telehealth are becoming key parts of AFib care. They allow continuous follow-up and convenience, which is increasingly important as the number of AFib patients grows.
This is especially important in rural or underserved areas, where seeing a specialist in person is difficult. Remote monitoring better ensures continuous care, early detection of complications, and faster interventions.
Getting AFib Under Better Control With Care and Technology
AFib may start with a skipped beat or a racing heart, but it’s far more than just an annoyance. In 2025, it’s a growing public health challenge. Fortunately, with the right mix of specialty care, long-term chronic management, and digital tools, like those associated with remote patient monitoring, people with AFib can live full, healthy lives.
And maybe — just maybe — get the orchestra of their heart back in tune.
Offering Remote Care Management to Patients
If you are interested in offering remote care management services to your patients, speak to the experts at Prevounce. Prevounce offers comprehensive cloud software, the Pylo line of cellular-connected devices, and expert services that simplify the provision of remote care management programs.