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This second edition explains the anatomy and physiology of the heart. It illustrates the changes in heart rate and rhythm that characterize atrial fibrillation. Further, it outlines the possible causes, symptoms, and complications, including the most significant risk— stroke. Treatment options to either cure or control atrial fibrillation are covered, including medications, catheter ablation, and the Maze Procedure.
Understanding Atrial Fibrillation
Treating Atrial Fibrillation
Living With Atrial Fibrillation
- Atrial Fibrillation is a type of rapid, irregular heartbeat.
- Some people can have Atrial Fibrillation and feel fine, others may develop symptoms like:
- Palpitations- an awareness of their own rapid heartbeat
- Shortness of breath
- Swelling in the feet
- Regardless of how you feel, Atrial Fibrillation needs to be treated right away or serious complications can develop.
- How the heart normally works:
- It is a muscle that relaxes and contracts, pumping blood carrying oxygen and nutrients throughout the body.
- The steady rhythm of contractions is controlled by electrical impulses that travel through the heart:
- First through the upper chambers, called the atria.
- Then through the lower chambers, called the ventricles.
- In order to reach the ventricles, electrical impulses must pass here, at the atrioventricular, or AV node.
- The physiology of Atrial Fibrillation:
- Atrial Fibrillation occurs when a storm of electrical impulses spread through the atria in a chaotic and disorganized pattern, causing the atria to begin rapidly contracting.
- The ventricles may also begin contracting faster.
- Episodes of Atrial Fibrillation can vary:
- It may only last a short time.
- It may continue to reappear.
- It can even become permanent. This is called Chronic Atrial Fibrillation.
- The effects of Atrial Fibrillation:
- When the heart is in Atrial Fibrillation, the body can't receive the blood and oxygen it needs.
- Left untreated, Atrial Fibrillation can cause blood clots that can lead to a stroke.
- Over time, a rapid heart rate can also weaken the lower chambers of the heart, causing other health problems.
- Causes of Atrial Fibrillation:
- The exact cause is often unknown
- High Blood Pressure
- Heart Disease
- Congestive Heart Failure
- Damage resulting from a heart attack or heart surgery
- Harmful substances, like alcohol, tobacco, and caffeine
- Before beginning treatment your doctor may want to further evaluate your heart with an echocardiogram:
- Uses sound waves to create an image of your heart as it pumps.
- The information from this and other tests will help you and you healthcare team decide on the treatment that is best for you.
- There are several treatment goals:
- For some patients with Atrial Fibrillation, restoring the heart's natural rhythm is the goal of treatment.
- For others, just controlling the heart rate is a safer and more effective goal.
- For most patients with Atrial Fibrillation, preventing blood clots that could lead to a stroke is extremely important.
- To help achieve your goals, several treatment options may be recommended.
- Antiarrhythmic medications may be given to restore the heart's natural rhythm:
- Rate Control medications help slow down the heart rate:
- Beta Blockers
- Calcium Channel Blockers
- Blood thinning medications are often prescribed to reduce the risk of stroke:
- Warfarin, sometimes called Coumadin
- Before having this procedure you'll be given a sedative to put you to sleep.
- An electrical shock is then delivered through the electrode pads, or paddles.
- This single shock wipes out the disorganized electrical activity in your heart, restoring the natural rhythm.
- Following electrical cardioversion, you may have a little chest discomfort, or some redness on the chest temporarily
- Most patients are allowed to go home a few hours after the procedure is completed.
- This procedure is not considered major surgery and is usually performed in an electrophysiology or heart catheterization lab.
- Before the procedure an IV will be started to provide you with medication to help you relax during the procedure. It may even put you to sleep.
- An area usually near the upper leg will be numbed and a small incision will be made and one or more catheters will be inserted into a vein and guided into your heart.
- To restore the heart's natural rhythm, the tissue conducting the abnormal impulses will be located. A catheter is placed against it, and radiofrequency energy is sent through the catheter, ablating, or destroying the tissue and restoring the heart's natural rhythm.
- Another option may be to ablate the AV node. This does not cure atrial fibrillation, but it does slow down the heart's rate, which reduces symptoms.
- After this procedure you may recover in the hospital for a few hours, or even overnight.
- When the AV node is ablated, this device is implanted to help the heart maintain an effective rate.
- A Pacemaker may also be recommended for some patients taking medications that slow down the heart rate.
- Making lifestyle adjustments can also help you manage your atrial fibrillation:
- If you have heart disease, continue to control your risk factors.
- Avoid things that could trigger or make your condition worse, like alcohol, tobacco and caffeine.
- Follow your medication instructions carefully, especially if you take Warfarin, which has very specific guidelines:
- Other medications can have an effect on Warfarin, so tell your doctor about any prescription or over-the-counter medications that you take.
- Foods high in Vitamin K, like broccoli and many leafy green vegetables can also interfere with Warfarin's action. So keep your diet steady.
- Take steps to avoid cutting yourself since Warfarin reduces your blood's ability to clot.
- Call your doctor if you notice signs of abnormal bleeding such as: bleeding from a cut or from your nose that won't stop, blood in your urine or stool, vomiting blood, abdominal pain or swelling, or unexplained bruises.
- Keep important contact information near the phone, or in your purse or wallet.
- You should also never be afraid to contact your healthcare team, go to the hospital, or call 911 if you experience: palpitations, dizziness, shortness of breath, fatigue, or swelling in the feet.
With time, you may be able to restore the heart’s natural rhythm. And even if you continue to experience Atrial Fibrillation, you can still maintain your health and continue to enjoy life.