Description

Atrial fibrillation (AFib) is an irregular and often rapid heart rhythm. An irregular heart rhythm is called an arrhythmia. Atrial fibrillation can cause blood clots in the heart. The condition also increases the risk of stroke, heart failure and other heart-related complications.

During atrial fibrillation, the heart's upper chambers — the atria — beat chaotically and irregularly. Beat out of sync with the lower chambers of the heart (the ventricles). For many people, atrial fibrillation may not have symptoms. But atrial fibrillation can cause a rapid, pounding heartbeat, difficulty breathing, or dizziness.

Episodes of atrial fibrillation may come and go, or they can be persistent. The atrial fibrillation itself usually is not life-threatening. But it is a serious medical condition that needs proper treatment to prevent stroke.

The treatment for atrial fibrillation may include medication, shock therapy to the heart in a regular rhythm and procedures of lock malfunction of the cardiac signals.

A person with atrial fibrillation may also have a connection with the heart rhythm problem called atrial flutter. Treatments for atrial fibrillation and atrial flutter are similar.

Symptoms

The symptoms of atrial fibrillation may include:

  • Feelings of a fast, palpitations or pounding heartbeat, called palpitations.
  • Pain in the chest.
  • The dizziness.
  • Fatigue.
  • The dizziness.
  • Decreased ability to exercise.
  • Shortness of breath.
  • The weakness.

Some people with atrial fibrillation (AFib) not notice any symptoms.

Atrial fibrillation can be:

  • Occasionally, also called paroxysmal atrial fibrillation. Atrial fibrillation symptoms come and go. The symptoms usually last a couple of minutes to hours. Some people have symptoms for as long as a week. The episodes may occur repeatedly. The symptoms may go away on their own. Some people with occasional atrial fibrillation need of treatment.
  • Persistent. The irregular heartbeat is steady. The heart rate is not reset on its own. If symptoms occur, medical treatment is necessary to correct the heart rhythm.
  • Long-standing persistent. This type of atrial fibrillation is constant and lasts for more than 12 months. Medications or a procedure is necessary to correct irregular heartbeats.
  • Permanent. In this type of atrial fibrillation, the irregular heart rhythm can't be restored. Medications that are necessary for the control of the heart rate and prevent blood clots.

When to see a doctor

If you have symptoms of atrial fibrillation, make an appointment for a health checkup. You may be referred to a doctor trained in diseases of the heart, called a cardiologist.

If you have chest pain, seek immediate medical help. Chest pain could mean you are having a heart attack.

Causes

To understand the causes of atrial fibrillation (AFib), can be useful to know how the heart normally beats.

The heart has four chambers:

  • The two upper chambers are called atria.
  • The two lower chambers are called the ventricles.

In the interior of the upper right part of the heart of the camera is a group of cells called the sinus node. The sinus node causes the signals that start with each beat of the heart.

The signals move through the upper chambers of the heart. Next, the signals that arrive at a group of cells called the AV node, where it is usually slower. The signals then go to the bottom chambers of the heart.

In a healthy heart, this signaling process usually goes well. The resting heart rate is usually 60 to 100 beats per minute.

But in atrial fibrillation, the signals in the upper chambers of the heart are chaotic. As a result, the top camera shake or stir. The AV node is flooded with signs trying to get through the lower chambers of the heart. This results in a fast and irregular heart rhythm.

In people with atrial fibrillation , the heart rate may be in the range of 100 to 175 beats per minute.

Causes of atrial fibrillation

Problems with the heart's structure are the most common cause of atrial fibrillation (AFib).

Heart disease and health problems that can cause atrial fibrillation include:

  • A problem of the heart that you are born with, it is called a congenital defect of the heart.
  • A problem with the heart's natural pacemaker, called sick sinus syndrome.
  • A sleep disorder called obstructive sleep apnea.
  • Heart attack.
  • Heart valve disease.
  • The high blood pressure.
  • Lung diseases, such as pneumonia.
  • The narrow or blocked arteries, called coronary artery disease.
  • Disease of the thyroid, such as hyperactivity of the thyroid.
  • Virus infections.

Heart surgery, or stress due to surgery or disease can also cause atrial fibrillation . Some people who have atrial fibrillation do not have heart disease or heart damage.

Lifestyle habits that can trigger an episode of atrial fibrillation may include:

  • Drinking too much alcohol or caffeine.
  • Use of illegal drugs.
  • Smoking or using tobacco.
  • Taking medicines that contain stimulants, including the common cold and allergies, medicines you have bought without a prescription.

Risk factors

Things that may increase the risk of atrial fibrillation (AFib), which include:

  • Age. The risk of atrial fibrillation increases as it grows.
  • Caffeine, nicotine, or the use of illegal drugs. Caffeine, nicotine and some illegal drugs — such as amphetamines and cocaine can cause your heart to beat faster. The use of these substances may lead to the development of more serious arrhythmias.
  • Drinking too much alcohol. Drinking too much alcohol can affect the electrical signals in the heart. This can increase the risk of atrial fibrillation.
  • Changes in the level of minerals in the body. The minerals in the blood called electrolytes, such as potassium, sodium, calcium and magnesium, helps the heart to beat. If these substances are too low or too high, irregular heartbeat, may occur.
  • The history of the family. An increased risk of atrial fibrillation occurs in some families.
  • Heart problems or a heart surgery. Coronary artery disease, heart valve disease, and problems with the heart present at birth increase the risk of atrial fibrillation . A history of heart attack or heart surgery also makes a person more prone to contracting the disease.
  • The high blood pressure. Having high blood pressure increases the risk of developing coronary artery disease. Over time, high blood pressure can cause the heart to become stiff and thick. This can change the shape of heartbeat signals travel through the heart.
  • Obesity. People who have obesity are at increased risk of developing atrial fibrillation.
  • Other long-term health conditions. You may be more likely to have atrial fibrillation if you have diabetes, chronic kidney disease, lung disease, or sleep apnea.
  • Some medications and supplements. Some prescription medications and certain cough and the flu bought without a prescription can cause irregular heart beats.
  • Disease of the thyroid. Have an overactive thyroid gland can increase the risk of irregular heartbeat.

Complications

Blood clots are a dangerous complication of atrial fibrillation (AFib). Blood clots can lead to stroke.

The risk of stroke from atrial fibrillation increases as it grows. Other health conditions can also increase the risk of a stroke due to atrial fibrillation . These conditions include:

  • The high blood pressure.
  • Diabetes.
  • Heart failure.
  • Some types of heart valve disease.

Blood thinners are commonly prescribed to prevent blood clots and stroke in people with atrial fibrillation.

Prevention

Healthy lifestyle can reduce the risk of heart disease and may prevent atrial fibrillation (AFib). Here are some tips to a healthy heart:

  • Control of high blood pressure, high cholesterol, and diabetes.
  • Do not smoke or use tobacco.
  • Eating a diet low in salt and saturated fat.
  • Exercise at least 30 minutes a day on most days of the week, unless your health care team says no.
  • Sleep well. Adults should get 7 to 9 hours a day.
  • Maintain a healthy weight.
  • Reduce and manage stress.

Diagnosis

You may not know that you have atrial fibrillation (AFib). The condition may be encountered when a health checkup is done for another reason.

To diagnose atrial fibrillation , your doctor will examine you and ask questions about your medical history and symptoms. The tests may be done to look for conditions that can cause irregular heartbeats, such as heart disease or thyroid disease.

Tests

Tests to diagnose atrial fibrillation (AFib) may include:

  • Blood tests. Blood tests are done to look for health conditions or substances that can affect the heart, or the beat of the heart.
  • Electrocardiogram (ECG or EKG). This quick and painless test that measures the electrical activity of the heart. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. The wires connect the electrodes to a computer, that prints or displays the results of the test. An ECG can show the rhythm of the heart and how slow or fast the heart is beating. It is the primary test for the diagnosis of atrial fibrillation.
  • Holter Monitor. This small portable ECG device that records the heart's activity. It is used for a day or two while you do your regular activities.
  • Event recorder. This device is as a Holter monitor, but the records only at certain times for a few minutes at a time. It is typically used for about 30 days. Normally push of a button when you feel symptoms. Some devices automatically record when an irregular heart rhythm is detected.
  • Implantable loop recorder. This device records the heart beats continuously for up to three years. It is also called a cardiac event recorder. The device shows how the heart beats while you do your daily activities. Can be used to see how often you have an episode of atrial fibrillation. Sometimes it is used to find rare episodes of atrial fibrillation in people at high risk of heart problems. For example, you may need one if you have had an unexplained stroke.
  • The echocardiogram. Use sound waves to create images of the beating heart. This test can show how blood flows through the heart and the heart valves.
  • The stress tests. These tests often involve walking on a treadmill or pedaling a stationary bike while the heart is controlled. The tests show how the heart responds to exercise. If you can't do the exercise, you may administer a drug that increases the heart rate as you exercise. Sometimes echocardiogram is performed during a stress test.
  • X-ray of the chest. An x-ray of the chest shows the condition of the lungs and the heart.

Treatment

The goals of atrial fibrillation treatment is to restore and control the beating of the heart and prevent blood clots.

The treatment depends on:

  • How much time you have had atrial fibrillation .
  • Their symptoms.
  • The cause of the irregular heartbeat.

Atrial fibrillation treatment may include:

  • Of medicine.
  • Therapy to restore the heart rhythm, called cardioversion.
  • Surgery or catheter procedures.

Together, you and your health care team to discuss the best treatment option for you. It is important that you follow your atrial fibrillation treatment plan. If the atrial fibrillation is not well controlled, it can lead to other complications, such as stroke and heart failure.

Drugs

The treatment for atrial fibrillation may include medications to do the following:

  • Control the speed of the heartbeat.
  • Restore the heart rhythm.
  • Prevent blood clots, a dangerous complication of atrial fibrillation .

The medications that may be used include:

  • Beta-blockers. These medications help to decrease the heart rate.
  • Calcium channel blockers. These medications control the heart rate, but may need to be avoided by people who have heart failure or low blood pressure.
  • Digoxin. This medication can control the heart rate at rest, but not during the activity. Most of the people you need additional information or alternative medications, such as calcium channel blockers or beta-blockers.
  • Medicines to control the heart rate and rhythm. Also called anti-arrhythmics, this type of medicine is used with moderation. They tend to have more side-effects than other medicines to control the rhythm of the heart.
  • A blood thinner. Also called blood thinners, these medicines help prevent blood clots and reduce the risk of stroke. Blood thinners include warfarin (Jantoven), apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa) and rivaroxaban (Xarelto). If you take warfarin, you may need to have regular blood tests to monitor the effects of the medicine.

Cardioversion therapy

If the atrial fibrillation symptoms are bothersome or if this is the first episode of atrial fibrillation, a doctor may try to reset the heart rhythm using a procedure called cardioversion.

Cardioversion can be done in two ways:

  • Electrical cardioversion. This method to reset the rhythm of the heart is done by sending electric shocks to your heart through paddles or patches placed on the chest.
  • Drug cardioversion. Drugs that are administered INTRAVENOUSLY or by mouth is used to reset the heart rhythm.

Cardioversion is usually done in a hospital as a scheduled procedure. You can, however, be carried out in emergency situations. If programmed, a blood thinner such as warfarin (Jantoven) may need to be taken for a couple of weeks before the procedure. The drug reduces the risk of blood clots and strokes.

After electrical cardioversion, medicines to control heart rhythm that may be necessary for life, to prevent future episodes of atrial fibrillation. Even with the medicine, atrial fibrillation may come back.

Surgery or catheter procedures

If the atrial fibrillation is not improved with medications or other treatments, a procedure called a cardiac ablation may be necessary. Sometimes the ablation is the first treatment.

Cardiac ablation is often used heat or cold energy to create small scars on the heart. The scars interrupt irregular heart signals and restore a typical beat of the heart. A doctor inserts a flexible tube called a catheter through a blood vessel, usually in the groin, and in his heart. More of a catheter can be used. The sensors in the tip of the probe is to apply cold or heat energy.

Less commonly, the ablation is performed using a scalpel during open heart surgery.

There are several types of cardiac ablation. The type used to treat atrial fibrillation depends on your specific symptoms, general health, and if you have another heart surgery.

  • Atrioventricular (AV) node ablation. The thermal energy is usually applied to the tissues of the heart in the AV node to destroy the electrical signaling connection. After this treatment, a pacemaker is necessary for life.
  • Maze procedure.A doctor uses the heat or the cold of the power, or a scalpel to create the pattern, or the maze of scar tissue in the upper chambers of the heart. Scar tissue does not send electrical signals. So the maze interferes with the loss of the heart signals that cause atrial fibrillation. If a scalpel is used to create the layout of the maze, an open-heart surgery is necessary. This is the so-called surgical maze procedure. It is the preferredAFibtreatment that you need another heart surgery, such as coronary artery bypass surgery or heart valve repair.
  • Hybrid ablation of atrial fibrillation. This therapy combines the ablation surgery. It is used for the treatment of long-standing persistent atrial fibrillation.
  • Pulsed field ablation. This is a treatment for some types of continuation of atrial fibrillation. Do not use heat or cold energy. Instead, it uses electrical pulses of high energy to create areas of scar tissue in the heart. The scar tissue blocks the defective electrical signals that cause atrial fibrillation .

Maze procedure. A doctor uses the heat or the cold of the power, or a scalpel to create the pattern, or the maze of scar tissue in the upper chambers of the heart. Scar tissue does not send electrical signals. So the maze interferes with the loss of the heart signals that cause atrial fibrillation.

If a scalpel is used to create the layout of the maze, an open-heart surgery is necessary. This is the so-called surgical maze procedure. It is the preferred treatment of atrial fibrillation that you need another heart surgery, such as coronary artery bypass surgery or heart valve repair.

Atrial fibrillation may return after cardiac ablation. If this happens, another of the ablation or treatment for the heart, may be recommended. After cardiac ablation, lifelong blood thinners may be needed to prevent strokes.

If you have atrial fibrillation, but they can't take blood thinners, you may need a procedure to seal a small pouch in the upper left part of the heart of the camera. This bag, called an appendix, is where the majority of atrial fibrillation-related clots form. This procedure is called the closure of the appendage of the left atrium. A closure device is gently guided through a catheter to the bag. Once the device is in place, the catheter is removed. The device is kept in permanent form. The surgical closure of the left atrial appendage is also an option for some people with atrial fibrillation who have another heart surgery.

Lifestyle and home remedies

After a heart-healthy lifestyle can help prevent or treat conditions that can lead to atrial fibrillation (AFib). The following changes are recommended to improve the health of the heart:

  • Eat healthy foods. Choose plenty of fruits, vegetables and whole grains. Limit the amount of sugar, salt and saturated fat.
  • Exercise and stay active. Regular physical activity helps to control diabetes, high cholesterol, and high blood pressure — all risk factors for heart disease. Try to get 30 to 60 minutes of physical activity most days of the week. Talk with your health care team about the amount and type of exercise is best for you.
  • Do not smoke. Smoking is a major risk factor for heart disease. If you need help to stop smoking, talk with your health care team.
  • Maintain a healthy weight. Being overweight increases your risk of heart disease. Talk with your care provider to set realistic goals for weight.
  • Control of blood pressure. Get your blood pressure checked at least every two years if you are under 18 years of age and older. If you have risk factors for heart disease, and has more than 40 years of age, you may need more frequent checks. If you have high blood pressure, follow your treatment plan as indicated.
  • Control your cholesterol. Ask your health care team how often you need a cholesterol test. Lifestyle changes and medications may be recommended to control high cholesterol.
  • Limit the consumption of alcohol. Excessive alcohol consumption (five drinks in two hours for men or four drinks for women) may increase the risk of atrial fibrillation. In some people, even smaller amounts of alcohol can trigger atrial fibrillation .
  • Practice good sleep habits. Lack of sleep can increase the risk of heart disease and other chronic conditions. Adults should aim to get 7 to 9 hours of sleep daily.

It is also important to have regular health screenings. Tell your health care team if your AFib symptoms get worse.

Preparing for your appointment

If you have an irregular or pounding heartbeat, make an appointment for a health checkup. If atrial fibrillation is detected early, treatment can be more easy, and can work better. You may be referred to a doctor trained in heart disease. This type of provider, it is called a cardiologist.

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of any pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet. For example, you may be asked not to eat or drink anything for a couple of hours before a cholesterol test.
  • Write down the symptoms you are experiencing, including any that may seem unrelated to atrial fibrillation. Note when they started, and what they were doing when they started.
  • Write important personal information, including any family history of heart disease, stroke, high blood pressure or diabetes, and any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking, including those bought without a prescription. Include the dose.
  • Bring someone along, if possible. Someone who goes with you can help you remember the information they give you.
  • Write down questions to ask your health care team.

For atrial fibrillation, some basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes for my symptoms or condition?
  • What kind of proof do you need?
  • What is the most appropriate treatment?
  • Is there a generic alternative to the medicine you're prescribing?
  • What other treatment options?
  • What foods should I eat or avoid?
  • What is an appropriate level of physical activity?
  • There are other restrictions that must be followed?
  • How often should I be screened for heart disease or complications of atrial fibrillation ?
  • I have other health conditions. How can I best manage them together?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

During a health checkup, you are usually asked many questions. Be prepared to answer them you can save your time to go through all the information that you want to spend more time. You may ask:

  • When did the symptoms begin?
  • Do you always have symptoms, or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

What you can do in the meantime

It is never too early to make a heart-healthy lifestyle changes, such as quitting smoking, eating healthy foods and getting more exercise. A healthy lifestyle is the main protection against heart problems and heart-related complications.

Symptoms and treatment of Atrial fibrillation