Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would explain that atrial fibrillation is the most common arrhythmia in humans and many individuals continue t operform their routine daily activity without being limited by this arrhythmia.

What is more important when dealing with atrial fibrillation individuals is the overall cardiac performance (atrial fibrillation is frequently an expression of a certain cardiomyopathy: valvular, hypertensive/hypertophic, dilated cardiomyopathy, etc.) and the status of ventricular rate.

If the overall cardiac performance (left and right ventricular election fraction) is not severely compromised and ventricular rate is adequately controlled, then it is quite possible to have an unrestricted daily activity with regard t ophysical activity.

So, regardless of the enlarged left atrium, if the left and right ventricles exhibit a nearly normal contractile function (preserved EF, almost normal dimensions and not severely impaired diastolic function) then you can perform several physical tasks without being limited (including walking up a small hill).

If such is the case (your cardiac performance checked by cardiac ECHO results satisfactory), then it is important to review your actual rate control therapy with your doctor.

Probably, you need to optimize your heart rate controlling therapy (choose the adequate drugs and their daily dosage).

You should know that even in the best therapeutic scenario, the overall physical performance of an individual with atrial fibrillation remains lower than in normal sinus rhythm individuals.

Coming to this point, I would recommend you discuss with your attending doctor on the possibility of checking cardiac performance by cardiac ultrasound (ECHO) and monitoring your heart rate by ECG and Holter monitoring (ambulatory 24 to 48 hours ECG monitoring) for a better judgement of the ongoing atrial fibrillation therapy.

Also, it is important to check other potentially responsible factor in your reduced physical ability by checking additional tests as follows:

- complete blood count (ruling out anemia),
- thyroid function tests (blood hormone levels),
- blood electrolytes level,
- chest X ray (checking lungs status)

If you provide me with cardiac echo report and any available mentioned tests, I could give a more direct professional opinion.

Hope you will find this answer helpful!

In case of any further uncertainties, fee lfree to ask me again.

Kind regards,

Dr. Iliri

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