Atrial Fibrillation: A Common Heart ProblemheadingContent
Atrial fibrillation or AFib is one of the most common heart rhythm problems. This is when the upper chambers of the heart or the atria have an abnormal, chaotic electrical activity and the heart rhythm becomes very irregular and usually fast. The blood in the atria may become sluggish and allow blood clots to form. Atrial fibrillation can be intermittent (paroxysmal), continue for several days (persistent), or be present all the time (permanent or chronic).
AFib affects almost 2.5 million adults in the United States annually. Most adults affected by AFib are over 65 years of age and it is more frequent in men than women. Almost any heart disease may lead to having atrial fibrillation. The most common causes are heart disease due to high blood pressure, heart attacks, heart failure and heart valve disease such as (mitral stenosis or insufficiency or complication of heart surgery). Other conditions that can cause AFib include excessive alcohol consumption – particularly binge drinking, thyroid disorders, sleep apnea, chronic lung disease (COPD), caffeine excess and certain medicines.
Some patients do not have any symptoms and the arrhythmia is found incidentally during a regular medical check-up. Other patients have mild symptoms like unpleasant palpitations or skipped beats, mild chest discomfort, feel lightheaded, have some shortness of breath and fatigue. Some patients may have more severe symptoms such as severe difficulty in breathing, fainting or near fainting, chest pain, profound fatigue or mental confusion.
A very serious complication of atrial fibrillation is stroke, which may lead to permanent brain damage and disability. This happens when a blood clot forms in the left atrium due to sluggish blood flow and a piece of the clot breaks off and enters the blood circulation which could block a blood vessel in the brain and stroke occurs. Those blood clots can also go to other parts of the body and cause other problems. The risk of stroke associated with AFib increases not only with the age, but also with diabetes, high blood pressure, heart failure and history of prior strokes. Atrial fibrillation can also increase the risk of heart attacks.
AFib is diagnosed with an electrocardiogram (EKG) that records the electrical activity of the heart. Sometimes it is necessary to conduct longer monitoring and a cardiologist may prescribe a holter monitor or an event recorder.
An echocardiogram (ultrasound of the heart) may be necessary to evaluate any structural heart disease. Blood tests are needed to screen for thyroid problems and some blood chemical abnormalities.
The management of atrial fibrillation could include:
- Medicines to control the speed and rhythm of heart
- Medicines to prevent blood clots from Some of the medicines used to treat this condition include: Warfarin (Coumadin), Dabigatran (Pradaxa), Rivaroxaban (Xarelto), Apixaban (Eliquis).
- Younger patients with low-risk may only require antiplatelet agents such as Aspirin
Treatment of AFib could include:
- Electrical cardioversion: involves applying a mild electrical shock to the heart to fix its
- Ablation therapy: uses heat or cold shocks to destroy small parts of the heart that are sending abnormal electrical signal
- Patients with atrial fibrillation or very slow heart rates may need a permanent
- Certain patients that cannot take anticoagulants may benefit from a small mechanical device that can be placed in the left atrium to prevent the clots from leaving the