Atrial Fibrillation (arrhythmia/abnormal heart rhythm)
What is Atrial Fibrillation?
Atrial fibrillation (AFib) is the most common sustained arrhythmia. It is a serious condition where the upper chambers of the heart beat irregularly leading to complications such as heart failure and stroke. When a stroke happens, it occurs due to a blood clot that lodges into the arteries leading to the brain. An estimated 15 – 20 percent of stroke victims were later found to have AFib. Unfortunately, many people are unaware that they have the condition, which afflicts at least 2.7 million Americans.
Atrial Fibrillation Symptoms
For many people, the first sign that something is wrong is feeling their heart skipping a beat, quivering or beating against their chest. Others report feeling light-headed, weak, or nauseated. However, 15-30% of patients with AFib do not feel any symptoms at all.
Atrial Fibrillation Diagnosis
After reviewing your health history and conducting a physical exam, your cardiologist may order one or more of the following tests:
Electrocardiogram (ECG) – This is the test typically used to diagnose Afib. It involves placing electrodes on the chest to detect the electrical currents your heart generates for muscular contractions to pump blood through the body. The test typically lasts less than several minutes minutes.
Ambulatory Monitor or Event Monitor – If your cardiologist wants further evaluation, a portable ECG may be used to track your heartbeat for an extended period of time. There are two types: An ambulatory monitor, also known as a Holter monitor, which may evaluate your heart function over a few days, weeks or even months. Event monitors allow for the same, but with information sent to your cardiologist in realtime.
Stress Test – Your cardiologist may also order a stress test to determine any changes in your heart’s electrical activity. It helps to identify typs of Afib that occur primarily during physical exercise or while you are under stress.
Atrial Fibrillation Treatments
The best treatments will take into account the severity and length of time you have had Afib, as well as any other medical conditions you may have. Treatment options may include one of more of the following:
Medications are usually used to prevent or treat blood clots that can lead to stroke. These include blood thinners and FDA-approved anticoagulants. Other medications can help control the heart rate or rhythm, but are less effective in patients with a longer history of arrhythmia. It is important to be aware of the side effects of any medications you take. Any of these drugs may be used in conjunction with other treatments.
- Electrical cardioversion uses electrical waves to “reset” the heart’s rhythm. It is typically performed on an outpatient basis under mild anesthesia.
- Radiofrequency ablation may be used when long-term medications or electrical cardioversion are not effective. It involves the use of a catheter to immobilize the area of the heart generating abnormal electrical activity. This is a minimally invasive procedure with a short recovery period.
- Left atrial appendage closure (or WATCHMAN closure) is a procedure to close off the left atrial appendage, which is a pouch on the left side of the heart where many blood clots arise from that can travel to cause a stroke. This procedure is an alternative to taking blood thinning medications for the correct patient.
- A pacemaker is a small device implanted into the body that delivers eletrical signals when necessary to regulate the heartbeat. The pacemaker may be connected to your heart by one or more wires. Tiny electric charges stimulate your heart when your heartbeat is too slow, too fast or irregular. Pacemakers work only when needed.
Maze heart surgery involves a surgeon making tiny cuts to the upper chamber of the heart to create scar tissue. The scars prevent the transmission of electrical charges that cause Afib and restore a normal heartbeat.