Atrial Fibrillation (AF) Care in Grand Rapids, Michigan

Atrial fibrillation (AF) is a common heart rhythm problem where the heart beats in an irregular and often fast fashion. It happens when the electrical signals that control your heartbeat become disorganized. Instead of beating in a steady pattern, the upper chambers of the heart (the atria) quiver or “fibrillate.”

In Grand Rapids and across West Michigan, AF is a major reason people see cardiologists at Spectrum Health (Corewell Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health.

How Common Is Atrial Fibrillation?

AF is the most common sustained arrhythmia (irregular heart rhythm lasting more than a few seconds).

  • Around 2 out of every 100 adults are affected overall
  • Less than 1% of people under age 50 have AF
  • Around 10% of people over age 75 are affected

Because Grand Rapids has a growing older adult population and high rates of high blood pressure and diabetes (similar to the rest of Michigan), AF is a frequent diagnosis in local primary care and cardiology clinics.

Cold Michigan winters can also contribute indirectly by:

  • Increasing blood pressure
  • Reducing physical activity
  • Worsening heart and lung conditions

All of these can add to AF risk.

How the Heart’s Electrical System Works

Normally, the heart’s electrical system follows a very organized pattern:

  1. Sinus node (natural pacemaker) in the right atrium sends out an electrical signal.
  2. This signal causes the atria (top chambers) to contract and push blood into the ventricles.
  3. The signal then travels to the atrioventricular (AV) node, and down into the ventricles (bottom chambers), causing them to contract and pump blood to the lungs and body.

In atrial fibrillation:

  • The sinus node no longer controls the rhythm properly.
  • The atria twitch or “shiver” instead of squeezing effectively.
  • The AV node receives a rapid, chaotic stream of signals.
  • The ventricles beat in a fast and irregular way.

This can reduce how efficiently the heart pumps blood and increase the risk of blood clots forming in the heart.

Symptoms of Atrial Fibrillation

AF can be silent (no obvious symptoms) and discovered only on a routine exam or EKG. This is one reason regular checkups with a Grand Rapids primary care provider are important, especially as you age.

When symptoms do occur, they may include:

  • Sensations of a fluttering or pounding heartbeat (palpitations)
  • Irregular or “skipping” heartbeat (often noticed by checking your pulse)
  • Chest discomfort or pain (angina)
  • Shortness of breath
  • Dizziness or lightheadedness
  • Fainting spells
  • Fatigue or general malaise
  • Reduced ability to exercise or climb stairs

If you have sudden chest pain, trouble breathing, or symptoms of a stroke (face drooping, arm weakness, speech trouble), call 911 or go to the nearest Grand Rapids emergency department (e.g., Spectrum Health Butterworth Hospital, Trinity Health Grand Rapids Hospital, Metro Health Hospital).

Types of Atrial Fibrillation

Doctors in Grand Rapids cardiology clinics will often describe AF using these categories:

  • One‑off (single episode) AF

    • A single episode of irregular heart rhythm
    • Sometimes triggered by heavy alcohol use (“holiday heart”), illness, or stress

  • Paroxysmal AF (occasional)

    • Repeated episodes that start and stop on their own
    • Episodes may last minutes to hours, sometimes up to 7 days

  • Persistent or Permanent AF (chronic)

    • The heart beats irregularly all or most of the time
    • May require long‑term medications and sometimes procedures
    • Often called “sustained” or “chronic” AF

More persistent types of AF are linked with a higher risk of stroke and heart failure.

Why AF Increases Stroke Risk

A stroke happens when blood flow to part of the brain is blocked, often by a blood clot.

In AF:

  • The atria do not squeeze effectively.
  • Blood can pool and stagnate in the atria, especially in a small pouch called the left atrial appendage.
  • Pooled blood is more likely to form a clot.
  • A clot can break loose, travel through the bloodstream, and block an artery in the brain, causing an ischemic stroke.

Without treatment, the risk of stroke in AF can be quite high. The risk is even greater if you also have:

  • High blood pressure (very common in Michigan)
  • Diabetes
  • Prior stroke or TIA (mini‑stroke)
  • Heart failure
  • Vascular disease (such as coronary artery disease)

AF also increases the risk of:

  • Heart failure (when the heart can’t pump blood effectively)
  • Heart attack, especially if AF is associated with coronary artery disease

Because of these serious risks, treating AF is important even if you feel fine and have no symptoms.

What Causes Atrial Fibrillation?

AF is often triggered by another health condition or event that irritates or stresses the heart.

Common causes and risk factors include:

  • Chronic high blood pressure (hypertension)
  • Heart valve disease that affects normal blood flow in the heart
  • Heart failure (impaired contraction or relaxation of the heart)
  • Coronary artery disease or prior heart attack
  • Overactive thyroid (hyperthyroidism)
  • Sleep apnea (very common in people who snore or have obesity)
  • Chest surgery (such as heart surgery)
  • Chest trauma (car accidents, sports injuries)
  • Excessive alcohol use (“binge” or chronic heavy drinking)
  • Certain prescription drugs that affect heart rhythm
  • Acute illnesses such as pneumonia, severe infections, or lung disease
  • Obesity and lack of exercise
  • Extreme endurance exercise in some people

Sometimes, especially as people get older, no single clear cause is found. Age‑related changes in the heart’s structure and electrical system increase AF risk even without other major risk factors.

In Grand Rapids and Kent County, high rates of high blood pressure, diabetes, obesity, and sleep apnea all contribute to AF being a common diagnosis.

How Atrial Fibrillation Is Diagnosed in Grand Rapids

If your doctor suspects AF, they will usually:

  • Ask about your symptoms and medical history
  • Perform a physical exam
  • Check your pulse and blood pressure

Common tests include:

  • Electrocardiogram (ECG or EKG)

    • A quick, painless test that records the heart’s electrical activity
    • Often done in primary care offices, urgent care centers, and hospital emergency departments in Grand Rapids

  • Holter monitor or event monitor

    • A small portable device worn for 24 hours or longer
    • Records your heart rhythm over time to catch intermittent AF episodes

  • Echocardiogram (heart ultrasound)

    • Uses sound waves to create images of your heart
    • Shows heart size, pumping function, valve problems, and structural issues

  • Blood tests

    • Check for thyroid problems, anemia, kidney and liver function, and other medical conditions that may trigger AF

You can access these tests through major health systems in Grand Rapids such as Spectrum Health, Trinity Health, Metro Health, and Mercy Health, as well as some independent cardiology practices.

Treatment Goals for Atrial Fibrillation

AF treatment in Grand Rapids follows national and international guidelines. The main goals are:

  1. Reduce the risk of stroke
  2. Control the heart’s rhythm and/or rate
  3. Improve symptoms and quality of life
  4. Treat underlying conditions and risk factors

Your cardiologist or primary care provider will tailor treatment based on your age, symptoms, other medical conditions, and stroke‑risk score.

Medications to Reduce Stroke Risk (Anticoagulants)

The most important part of AF treatment is usually anticoagulation—medications that reduce the blood’s ability to clot and therefore lower stroke risk.

These are commonly called “blood thinners,” but they do not actually thin the blood; they change how it clots.

Effective Anticoagulant Medications

The main proven options for AF are:

  • Warfarin

    • Older medication, still widely used
    • Requires regular blood tests (INR) and dose adjustments
    • Affected by diet (especially vitamin K) and other medications

  • NOACs / DOACs (Novel/Direct Oral Anticoagulants), including:

    • Dabigatran
    • Apixaban
    • Rivaroxaban

These newer medications:

  • Do not require routine INR blood testing
  • Have fewer food interactions
  • Are at least as effective as warfarin for stroke prevention in AF

There is little difference in overall effectiveness among these drugs. Your Grand Rapids provider will help choose the best option based on your kidney function, other medications, insurance coverage, and personal preferences.

Medications That Do Not Prevent AF‑Related Stroke

Aspirin and clopidogrel are sometimes called “blood thinners,” but:

  • They are not effective for preventing stroke in AF
  • They should not be used alone for AF stroke prevention

Bleeding Risks

All anticoagulants increase the risk of bleeding, including serious bleeding (such as in the brain or stomach). This means:

  • These drugs can rarely cause a type of stroke (bleeding in the brain)
  • However, for most people with AF, the benefits of preventing clots and ischemic strokes outweigh the bleeding risks

Your doctor will use scoring tools (such as CHA₂DS₂‑VASc for stroke risk and HAS‑BLED for bleeding risk) and consider:

  • Age and sex
  • History of stroke or TIA
  • Heart failure
  • High blood pressure
  • Diabetes
  • Vascular disease
  • Liver or kidney problems
  • Prior bleeding

Shared decision‑making with your provider is essential.

Medications to Control Heart Rhythm

Some people with AF are treated with medications that try to restore and maintain a normal heart rhythm (called “rhythm control”).

Common anti‑arrhythmic medications include:

  • Sotalol
  • Flecainide
  • Amiodarone

These may be given as:

  • Tablets for long‑term control
  • Injections in a hospital setting to convert AF back to normal rhythm

Because some of these medications can cause side effects or toxicity, you may need regular blood tests to monitor:

  • Liver function
  • Thyroid function
  • Kidney function
  • Other safety parameters

Medications to Slow the Heart Rate

Even if AF continues, controlling how fast the heart beats can relieve symptoms and improve how you feel. This is called rate control.

Common rate‑controlling medications include:

  • Beta‑blockers (e.g., atenolol, metoprolol)
  • Calcium channel blockers (e.g., diltiazem, verapamil)
  • Digoxin

These medications:

  • Help slow the heart rate
  • Can reduce palpitations and shortness of breath
  • Are often used long‑term

Your provider will monitor your heart rate and blood pressure regularly, especially when starting or adjusting these medications.

Electrical Cardioversion

Electrical cardioversion is a procedure that delivers a controlled electrical shock to the chest to “reset” the heart’s rhythm back to normal.

  • Done under general anesthesia or sedation, so you are asleep and comfortable
  • Often performed in a hospital setting (e.g., Spectrum Health Butterworth Hospital, Trinity Health Grand Rapids)
  • May be recommended if:
    • AF has started recently
    • Medications alone are not enough
    • Symptoms are significant

Even after successful cardioversion, long‑term medication is often needed to keep the heart in normal rhythm and to prevent stroke.

Surgical and Catheter‑Based Treatments for AF

Most people in Grand Rapids with AF respond well to non‑surgical treatments (medications and cardioversion). For more severe or persistent cases, or when medications are not effective or cause side effects, procedural options may be considered.

These are usually performed by an electrophysiologist (a cardiologist specializing in heart rhythm disorders).

Catheter Ablation

Catheter ablation is a minimally invasive procedure that targets and destroys small areas of heart tissue that trigger AF.

Basic steps:

  1. A cardiologist makes a small incision in the groin or upper thigh.
  2. A thin tube (catheter) is inserted into a large blood vessel and guided to the heart.
  3. The catheter tip has an electrode that delivers radiofrequency energy (or sometimes freezing energy).
  4. This energy creates tiny scars in the problem areas, disrupting abnormal electrical circuits that cause AF.

Catheter ablation:

  • Can reduce or eliminate AF episodes in many patients
  • Is commonly available at major Grand Rapids heart centers and electrophysiology labs

Maze Procedure

The maze procedure is a surgical treatment that creates a pattern (“maze”) of small scars in the atria to block abnormal electrical pathways and allow the sinus node to regain control.

  • Most often performed during open‑heart surgery being done for another reason (such as valve repair or coronary bypass)
  • Sometimes done using minimally invasive approaches in specialized centers

Your cardiologist and cardiac surgeon will discuss whether this is appropriate based on your overall heart condition.

Lifestyle Changes to Help Manage AF in Grand Rapids

Lifestyle changes are a critical part of AF treatment and prevention, especially in a region like West Michigan where:

  • Winters are long and cold
  • Physical activity may drop seasonally
  • Rates of obesity, high blood pressure, and diabetes are significant

Your doctor may recommend:

  • Control high blood pressure

    • Take medications as prescribed
    • Reduce salt intake
    • Monitor blood pressure at home

  • Lose excess weight

    • Even modest weight loss can reduce AF burden
    • Consider working with a local dietitian or weight‑management program

  • Exercise regularly

    • Aim for moderate activity (like brisk walking) most days, indoors or outdoors
    • Use indoor options (gyms, community centers, mall walking) during icy or very cold Grand Rapids winters

  • Reduce alcohol consumption

    • Limit or avoid binge drinking, which can trigger AF episodes

  • Quit smoking

    • Smoking damages blood vessels and increases heart disease risk
    • Grand Rapids and Kent County offer smoking cessation programs and resources

  • Manage diabetes

    • Keep blood sugar under control
    • Work closely with your primary care provider or endocrinologist

  • Treat sleep apnea

    • If you snore loudly, feel very tired during the day, or have observed breathing pauses during sleep, ask about a sleep study
    • CPAP treatment can significantly improve AF control in many patients

  • Stay active year‑round

    • Cold weather can make it tempting to stay sedentary—look for safe indoor exercise options in Grand Rapids (YMCA, community recreation centers, home exercise routines).

Local Resources for AF Care in Grand Rapids, MI

If you suspect you have AF or have already been diagnosed, you can seek care and support from:

  • Your primary care provider (GP/family doctor)

    • First point of contact for evaluation, initial testing, and referrals

  • Cardiologists and electrophysiologists at:

    • Spectrum Health (Corewell Health)
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Mercy Health

  • Kent County Health Department & Grand Rapids Public Health resources

    • Programs for blood pressure control, diabetes prevention, smoking cessation, and heart‑healthy living

  • Heart organizations and support

    • National Heart organizations and online support groups
    • Local hospital‑based heart failure and arrhythmia clinics

In any emergency (chest pain, severe shortness of breath, signs of stroke), call 911 immediately.

Key Takeaways About Atrial Fibrillation

  • AF is the most common sustained arrhythmia.
  • It may cause palpitations, chest discomfort, dizziness, or no symptoms at all.
  • Stroke risk is significantly increased in AF, even if you feel well.
  • Anticoagulant medications (warfarin or NOACs like apixaban, dabigatran, rivaroxaban) are the only proven way to reduce AF‑related stroke risk.
  • Treatment options include:
    • Medications to reduce stroke risk
    • Medications to control heart rhythm
    • Medications to slow heart rate
    • Electrical cardioversion
    • Catheter ablation or maze surgery in selected cases
  • Lifestyle changes—controlling blood pressure, losing weight, exercising, limiting alcohol, quitting smoking, and managing diabetes—are essential for long‑term AF control, especially in the Grand Rapids, Michigan climate and health environment.

If you live in the Grand Rapids area and are concerned about irregular heartbeats or AF, schedule an appointment with your primary care provider or a local cardiologist to discuss evaluation and treatment options. Early diagnosis and proper management can greatly reduce your risk of stroke and other complications.