Atrial Fibrillation

What is atrial fibrillation?
Atrial fibrillation (also called AF or A-fib) is an abnormal rhythm of the heart. It is relatively common, affecting over 2 million people in the United States. Due to an aging population it is estimated that as many as 12 million individuals may be affected by AF by the year 2050.

A highly organized electrical system causes the human heart to beat. When the body’s natural pacemaker (known as the SA node) is functioning, an individual is said to be in “normal sinus rhythm.” A normal heart rate beats between 60 and 80 beats times each minute.

When AF occurs, the electrical activity of the heart is disorganized, causing an irregular heartbeat. When someone is in AF, the top chambers of heart (the atria) beat at approximately 300-600 times per minute. Under certain circumstances, the bottom chambers of the heart (the ventricles) beat at very fast as well. This condition is known as “atrial fibrillation with rapid ventricular response.”

 

What are some of the risk factors for atrial fibrillation?
It is estimated that one out of every four individuals will develop AF in their lifetime. Certain risk factors are associated with a greater likelihood of developing AF including:

  • Advancing age
  • High Blood Pressure
  • Diabetes
  • Preexisting Heart Failure
  • Congenital Heart Disease
  • Valvular Heart Disease
  • Thyroid disease
  • Coronary Artery Disease
  • Sleep apnea
  • Lung disease
  • Excessive alcohol or stimulant use
  • Serious illness or infection
  • Surgery (particularly open-heart surgery)

 

What are the dangers of atrial fibrillation?
Some people live for years with AF without any problem. Many people don’t even know that they are in AF until it is discovered incidentally. Others know the minute they go into AF because of the symptoms they experience. Either way, AF can have devastating and long-term effects on one’s health.

 

What are the symptoms related to atrial fibrillation?
Some people have no symptoms at all while others have disabling symptoms. Mild symptoms include:

  • Unpleasant palpitations or irregularity of the heart beat
  • Mild chest discomfort (sensation of tightness) or pain
  • A sense of the heart racing
  • Lightheadedness
  • Mild shortness of breath and fatigue that limits the ability to exercise


Severe symptoms include:

  • Difficulty breathing
  • Fainting or near fainting
  • Chest discomfort
  • Any symptom associated with stroke (weakness, slurred speech, numbness, confusion)

 

 

How is atrial fibrillation detected?
AF is usually diagnosed with an electrocardiogram (ECG or EKG), which records the heart’s electrical activity. Other tests, such as an echocardiogram (ultrasound), may be performed to look for heart failure or heart valve problems. Blood tests may be used to screen for thyroid disorders. Occasionally, sleep studies and lung function tests are sometimes used to look for sleep apnea or underlying lung disease.

 

What are the treatment options for atrial fibrillation?
Fortunately there are many treatment options for AF. You should discuss with your doctor regarding which treatment plan makes sense for you.

The goals of AF treatment may include the following:

  • Returning the heart to a normal rhythm,
  • Reducing symptoms related to AF and improving quality of life.
  • Controlling the heart rate.
  • Preventing blood clots from forming in the heart.


A “rate control” strategy focuses on reducing the symptoms of AF by controlling a patient’s heart rate. A “rhythm control” strategy focuses on keeping patients in a normal sinus rhythm.

 

Stroke Prevention
Stroke can be a devastating consequence of atrial fibrillation. For a given individual the risk of stroke due to AF is dependant on many factors.

  • Low-risk AF patients may need to take an aspirin each day to reduce there risk of stroke.
  • Patients who are at higher risk for stroke may be required to take blood thinners known as anticoagulants to help prevent blood clots from forming in the heart.
  • High risk patients who cannot tolerate anticoagulants may be eligible to have a non-surgical procedure designed to reduce the risk of stroke related to AF.