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ATRIAL FIBRILLATION

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ATRIAL FIBRILLATION

Atrial fibrillation is a heart condition characterized by irregular and often rapid heart rate.

  • The heart is made up of four chambers – two upper chambers (atria) and two lower chambers (ventricles).
  • A group of cells called the sinus node is located within the upper right chamber of the heart (right atrium).
  • The sinus node is the heart’s natural pacemaker. It initiates the electrical impulse that travels through the heart, causing it to beat in a regular rhythm and heart rate.
  • The electrical impulse generated by the sinus node travels first through the atria and then through the atrioventricular (AV) node (a connecting chamber between the upper and lower chamber of the heart).
  • As the signal passes from the sinus node to the atria, they contract to force blood into the ventricles.
  • As the signal passes through the AV node to the ventricles, it signals the ventricle to contract, pumping blood out and around the body. The AV node acts as a gate, slowing down the electrical signal before it enters the ventricles.
  • In atrial fibrillation, the two upper chambers of the heart are affected, disrupting the flow of blood to the ventricles and the rest of the body.
  • The upper chamber of the heart experiences abnormal electrical impulses making them to quiver. The result is a fast and irregular heart rhythm.
  • A normal heart rate should be between 60 and 100 beats a minute.
  • In atrial fibrillation, the heart rate can range between 100 and 175 beats a minute.
  • The condition can be deadly if left untreated. It is a serious medical condition that requires emergency treatment.
  • Serious complications include stroke and heart failure.
  • It is common in people older than 65 years of age

CAUSES

  • High blood pressure
  • Coronary artery disease
  • Abnormal heart valves
  • Congestive heart failure
  • Thyroid disease
  • Binge drinking
  • Congenital heart defects
  • Previous heart surgery
  • An overactive thyroid gland
  • Viral infections
  • Exposure to stimulants such as tobacco, excessive alcohol or certain medications
  • Lung diseases such as pneumonia, lung cancer, sarcoidosis, and pulmonary embolism
  • Obstructive sleep apnea
  • Pericarditis
  • Hypertrophic cardiomyopathy, a thickening of the heart muscle.

Risk factors may include:

  • Obesity
  • A family history of the condition
  • Age, the older you are, the higher the risk

SYMPTOMS

You may not experience any symptoms if you have the condition. If symptoms exist, they may include:

  • Heart palpitations
  • Fatigue
  • Weakness
  • Confusion
  • Lightheadedness
  • Fainting
  • Shortness of breath
  • Reduced ability to exercise
  • Dizziness

Atrial fibrillation may be:

Paroxysmal atrial fibrillation – episodes may come and go, lasting for a few minutes to hours and resolves within 48 hours on its own.

Persistent atrial fibrillation- episodes last longer than 7 days or less when it is treated.

Long-standing atrial fibrillation-episodes last for a year or longer

Permanent atrial fibrillation- atrial fibrillation is present all the time, and the abnormal heart rhythm can’t be restored.

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will review your medical history, symptoms, and conduct a physical examination. The doctor may order the following test to make a diagnosis:

  • Electrocardiogram to sense and record the electrical signals as they travel through the heart.
  • Holter monitor that you wear for a day or two and that monitors your heart rhythm as you go about your daily routine.
  • An echocardiogram that uses ultrasound to measure heart muscle.
  • Stress Test to check if exercise is triggering or could worsen your condition. This test involves running a test on your heart as you are exercising
  • Blood tests to rule out thyroid problems or other substance in the blood that may cause your condition.
  • Chest X-ray to allow the doctor to see the conditions of your lung and heart.
TREATMENT

The aim of treatment is to control heart rate, decrease the risk of strokes, and prevent blood clots.

Treatment options may include:

Cardioversion – where the heart is given a controlled electric shock to reset the heart to its regular rhythm.

Catheter ablation – where hotspots inside the heart that is causing the atrial fibrillation are destroyed using radiofrequency energy, cryotherapy (extreme cold), or heat to normalize the erratic signals.

Medications to prevent stroke

Blood thinners to prevent blood clots