What Is Atrial Fibrillation (A-Fib)?
Atrial Fibrillation is the most common heart arrhythmia (irregular heartbeat). Over two million (2.7) people Americans are living with atrial fibrillation. Although it is not life-threatening, it can cause uncomfortable symptoms. It can also cause other problems such as congestive heart failure and stroke. To fully understand atrial fibrillation, you need to know how the normal heart works. Atrial fibrillation may be temporary, may come and go, or may be permanent. It’s also most common in adults over the age of 65. But with proper medical care, you can live a normal, active life. The cause of atrial fibrillation isn’t always known. Conditions that can cause damage to the heart and lead to atrial fibrillation include:
- High blood pressure
- Congestive heart failure
- Coronary artery disease
- Heart valve disease
- Hypertrophic cardiomyopathy, in which the heart muscle becomes thick
- Heart surgery
- Congenital heart defects, meaning heart defects you’re born with
- An overactive thyroid gland
- Pericarditis, which is inflammation of the sac-like covering of the heart
- Taking certain medications
- Binge drinking
- Thyroid disease
An overall healthy lifestyle may decrease your risk of A-Fib. But not all causes are preventable.
Types of Atrial Fibrillation
With atrial fibrillation, there is an abnormal focus of electrical impulses that cause the atria to fibrillate or quiver rather than contract in a regular pattern. The storm of impulses is sent to the AV node, which conducts some of the impulses through to the ventricle. If the impulses are rapidly conducted the ventricular rate can be very fast. Some people experience atrial fibrillation on and off, which is classified as
ü Paroxysmal AF – A-Fib that occurs sometimes and then stops. AFib stops by itself and the heart returns to normal rhythm. AFib may last for seconds, minutes, hours, or days before the heart returns to its normal rhythm. People with this type of A-Fib usually have more symptoms than others. As the heart goes in and out of AFib, the pulse rate may change from slow to fast and back again in short periods of time.
ü Persistent AF – A-Fib that does not stop by itself. Medications or a special type of electrical shock (called cardio-version) is used to help the heart return to normal rhythm. If no treatment is given, the heart will stay out of rhythm.
ü Long standing persistent AF (formerly known as Permanent AF) – A-Fib that cannot be corrected. Medications and controlled electrical shock cannot help return the heart to normal rhythm
Atrial Fibrillation Symptoms
Some people are not symptomatic with atrial fibrillation. Other people can feel one or more of the following symptoms: palpitations, fluttering, shortness of breath, particularly with exertion such as climbing a flight of stairs or walking up an incline, chest pressure or discomfort and lightheadedness.
Causes of Atrial Fibrillation
Damage to or an abnormality of the heart can be the cause of atrial fibrillation. Some of the causes of damage include:
ü Coronary artery disease
ü Viral infection
ü Sleep apnea
Some abnormalities of the heart that can cause atrial fibrillation include abnormal heart valves and various congenital heart defects.
Atrial fibrillation, if it is persistent or permanent, can be diagnosed with a 12 lead electrocardiogram (EKG). If it comes and goes then it may not be seen on a routine EKG. Then a prolonged cardiac monitor can be used to make the diagnosis.
Atrial Fibrillation (A-Fib) Treatment
Since the atria are not emptying properly when in fibrillation, blood clots can develop and travel to vessels in the head causing a stroke. It is important for people experiencing atrial fibrillation to be treated with an anticoagulant (i.e. blood thinner) such as Warfarin (Coumadin), Pradaxa, Eliquis, Xarelto or aspirin.
What Is Atrial Fibrillation Ablation?
If a person experiences frequent episodes of paroxysmal or persistent atrial fibrillation despite medication therapy, ablation therapy may be an option to prevent further episodes. Ablation therapy is when an energy source, currently radiofrequency energy, is applied to an area of the heart that is a focus for an arrhythmia. In the case of atrial fibrillation, research shows that the source of electrical irritability is surrounding the os (opening) of each of the pulmonary veins.
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