What Is Atrial Fibrillation
Atrial fibrillation (AFib) is an interruption in your heart's precision beating, creating an irregular and often rapid heart rate. AFib often begins as brief periods of abnormal beating, which become longer and longer over time. Though there are usually no symptoms, atrial fibrillation must be taken seriously because it can increase your risk of stroke, heart failure and other heart related complications.
AFib is more common in men than women, and risk increases with age. The three main types of atrial fibrillation are paroxysmal atrial fibrillation, which occurs briefly and then goes away, persistent atrial fibrillation, which lasts longer than seven days and persistent atrial fibrillation, which lasts a year.
Symptoms of Atrial Fibrillation
Atrial fibrillation often has no symptoms, but it can cause symptoms when it is not treated. The following most common symptoms may resemble other conditions or medical problems, so it's always best to talk with your doctor if you experience:
Heart palpitations: the sensation in which your heart is skipping beats or beating too hard.
- Shortness of breath
- Chest pain
- Dizziness
- Fainting
- Weakness
- Fatigue
- Confusion
- Swelling in the feet, ankles and legs
Symptoms for atrial fibrillation can range from occasional to permanent.
- Occasional
- Persistent
- Long-standing persistent
- Permanent
Causes of Atrial Fibrillation
The heart's structure can commonly be the leading cause of atrial fibrillation.
Possible causes of atrial fibrillation include:
- Coronary artery disease
- Heart attack
- Heart defect that you're born with (congenital heart defect)
- Heart valve problems
- High blood pressure
- Lung disease
- Physical stress due to surgery, pneumonia or other illness
- Previous heart surgery
- Problem with the heart's natural pacemaker (sick sinus syndrome)
- Sleep apnea
- Thyroid disease such as an overactive thyroid (hyperthyroidism) and other metabolic imbalances
- Uses of stimulants, including certain medications, caffeine, tobacco, and alcohol
- Viral infections
Atrial Fibrillation Diagnosis
At INTEGRIS Health, we use the most advanced imaging methods and diagnostic tools to determine the cause, severity and prognosis of your heart condition. Diagnosis starts with a medical history and physical exam, and you may be sent to a cardiologist for further evaluation and treatment.
Diagnostic tests may include:
- Electrocardiogram (ECG): Health care providers use this very important diagnostic test to study the heart signal and rhythm. A skilled reader can find atrial fibrillation using this test alone. If the atrial fibrillation comes and goes, you might need an electrocardiogram over a longer period while wearing a Holter monitor or an event recorder to pick up the rhythm.
- Echocardiogram: Checks the heart's structure and function.
- Cardiac Stress Testing: Checks the blood flow in the heart.
- Blood Work: Checks for thyroid levels, diabetes and possible medical conditions.
Treatment for Atrial Fibrillation
Your doctor will determine specific treatment for atrial fibrillation based on your age, overall health, medical history, disease extent, and tolerance for specific medications, procedures or therapies. Of course, your personal opinions and preferences will also be taken into consideration. In the long term, treatment focuses on controlling the heart rate or preventing the abnormal rhythm.
Treatments may include:
- Anticoagulation Medicines: What you are prescribed will depend on your risk for stroke. If you are at low risk, you may take daily aspirin. If you are at high risk, you will need a stronger blood thinner.
- Other Medicines: To slow the heartbeat (beta-blockers and calcium channel blockers), to help prevent atrial fibrillation (antiarrhythmics) or to treat heart failure if present (like ACE inhibitors)
- Cardioversion: Your health care provider sends an electrical shock to your heart through the chest. This can help the heart get back into a normal rhythm. You are connected to an ECG monitor, which is also connected to the defibrillator.
- Ablation: An invasive but nonsurgical procedure done in the electrophysiology lab if medicines and cardioversion have not worked. The health care provider puts a thin, flexible tube (catheter) into your heart through a vessel in your groin or arm. The provider uses a method such as radiofrequency ablation (which heats the tissue) or cryoablation (which freezes the tissue). Either way, the goal is to destroy the small patch of heart tissue which causes atrial fibrillation. In some cases, the conduction node between the atria and the ventricles will be destroyed, preventing the problem signals from passing to the ventricles. A pacemaker is then put into control heart rhythm.
- Maze Surgery: Several incisions or burns are made on the left and right atria. This forms scar tissue, which does not conduct electricity, disrupting the path of abnormal electrical impulses and thus preventing atrial fibrillation.
- Prothrombin Time: This test is needed if you take warfarin. It measures the time it takes for your blood to clot and records your reading as an international normalized ratio. Your doctor can then change your medicine if needed. Newer anticoagulant medications may call for periodic monitoring of your kidney function.
