Atrial fibrillation

Overview – Atrial fibrillation is a heart rhythm disorder characterized by irregular and often rapid heart rate.

The atria, upper chambers beat irregularly and there is no coordination with the ventricles, the lower chambers of the heart. The heart rate in atrial fibrillation may range from 100 to 175. The normal heart rate is 60 to 100 beats a minute.

The underlying conditions that predispose the heart to atrial fibrillation are hypertensive heart disease, coronary heart disease, rheumatic heart disease.

The other risk factors for atrial fibrillation are valvular heart disease, diabetes, chronic kidney disease, chronic lung disease, thyroid problems, binge drinking, obesity.

 

SymptomsSome people with atrial fibrillation have no symptoms. Others may experience –

  • Palpitations
  • Lightheadedness
  • Dizziness
  • Shortness of breath
  • Chest pain
  • Weakness

 

Complications

  • The potential complication of atrial fibrillation is the development of blood clots in the upper chambers of the heart. These blood clots may circulate to other organs and lead to decreased blood supply. This embolization of blood clots may cause a stroke.
  • Heart failure.

 

Seek immediate medical help if you experience –  Face droop on one side when you try to smile; slurred speech; weakness or numbness on one side of the body, including either leg; severe headache; blurring or loss of vision; dizziness as these may be symptoms and signs of a stroke.

 

Diagnosis

  • Electrocardiogram, Holter monitor (portable electrocardiogram device that records your heart’s activity for 24 hours or longer), event recorder (the device that records the heart’s activity over weeks to few months and records the event when the patient experience the symptoms) may be used to diagnose atrial fibrillation.
  • An echocardiogram is done to assess the heart’s function and structures.
  • Blood tests are done to rule out other causes of atrial fibrillation.
  • A chest x-ray and stress test will also be done to check the condition of your heart and lungs.

 

Medical management

  • Treatment of atrial fibrillation includes heart rate and rhythm control and prevention of blood clots.
  • Electrical cardioversion or cardioversion with medications are treatment to reset the heart rhythm. Warfarin or other blood-thinning medications may be given several weeks before the cardioversion or at least a month after the cardioversion to reduce the clots.
  • Dofetilide, flecainide, amiodarone, sotalol are anti-arrhythmic medications that are used after electrical cardioversion to prevent future episodes.
  • Medications that may be used to control the heart rate are beta-blockers, digoxin, calcium channel blockers.
  • Other options include surgical procedures such as catheter ablation, maze procedure, atrioventricular node ablation.
  • Blood-thinning medications used to prevent clots includes warfarin, dabigatran, rivaroxaban, apixaban, edoxaban.

 

Lifestyle management

  • Follow a healthy diet and exercise program as recommended by your doctor. Diet should be low in salt and solid fats.
  • Maintain a healthy weight.
  • Do not smoke.
  • Limit your caffeine intake. Do not drink alcohol
  • Intense stress and anger can worsen atrial fibrillation.
  • Talk to your doctor if you are taking or planning to take any medications. Some medications like cold and cough medications might trigger a rapid heartbeat.
  • Keep all the appointments with your doctor.

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