ATRIAL-FIBRILLATION
Atrial fibrillation is a condition which causes an irregular and often rapid heart rate. It can put you at risk for blood clots, stroke and heart failure.
The heart normally contracts and relaxes to a regular beat. In atrial fibrillation, the two upper chambers of the heart (the atria) beat irregularly (quiver or twitch) instead of beating effectively to move blood into the ventricles. This in turn causes your heart rate to become irregular and causes it to beat faster than usual.
- Paroxysmal atrial fibrillation– Atrial Fibrillation
- Persistent atrial fibrillation– Atrial Fibrillation
- Long-term persistent atrial fibrillation– Atrial Fibrillation
- Permanent atrial fibrillation
Most of the time, this condition causes no symptoms and may be detected during a routine health check; however, some may experience the following:
- Palpitations
- Tiredness or fatigue
- Dizziness or light-headedness
- Shortness of breath
- Chest pain
What are the causes?
- Advanced age
- Previous heart attack (myocardial infarction)
- High blood pressure (hypertension)
- Valve disease
- Congenital heart disease
- Cardiomyopathy (enlarged heart)
- Thyroid disorders
- Obesity
- Sleep apnea
- Chronic lung diseases
- Excessive consumption of caffeine, alcohol, or tobacco.
Evaluation starts with a complete history and physical examination.
ECG and an echocardiogram are performed to look for cardiac function and decreased blood flow to the heart.
Blood tests to rule out anemia, infections, electrolytes disturbances, thyroid and kidney disorders are performed.
In some patients, a 24-hour Holter (ECG) monitoring is also done.
How is it treated?
Treatment depends on multiple factors such as the duration, intensity, and the cause of atrial fibrillation. Medications are prescribed which keeps the heart rate in control. Blood thinners known as anticoagulants are prescribed to prevent formation of blood clots.
Resetting of the heartrate is sometimes done through Electrical Cardioversion in which an electric shock is delivered to the chest.
Ablation is performed when long-term medications or electrical cardioversion are not effective. A thin tube (catheter) is inserted into the patient’s blood vessels and is guided to the heart. Once the tissue which causes the arrhythmia is identified, energy (such as radiofrequency, laser, or cryotherapy) is delivered and the tissue is destroyed to prevent further arrhythmias.
Rarely, surgery may be necessary. In the Maze procedure, the surgeon makes multiple small incisions in the upper chambers (atria) of the heart which are then stitched together forming scar tissue. These scars interfere and prevent the transmission of the abnormal impulses.