Atrial fibrillation

Atrial fibrillation is the most common rhythm abnormality affecting the heart and occurs with increasing frequency as we age. The normal and organized electrical signals that typically control heart contractions are replaced with chaotic activation of the top heart chambers with multiple waves of electrical activity during atrial fibrillation. As a result, the top chambers quiver rather than contract. Additionally the bottom chambers tend to contract irregularly and at a faster rate than normal. Atrial fibrillation is typically “paroxysmal” or intermittent when it first affects a person. Overtime, it tends to occur more frequently and become “persistent.”

Some people feel very little or no symptoms, however, most people experience some symptoms with atrial fibrillation. The primary symptoms of atrial fibrillation include racing heart rates, an irregular feeling of heart beats, fatigue, shortness of breath, mild chest tightness, and lightheadedness. In addition to the nuisance of its primary symptoms, due to the ineefective contraction of the top chambers and subsequent blood pooling and stasis, atrial fibrillation increases the risk of having a stroke.

PATH NETWORK: ATRIAL FIBRILLATION

How Is AF diagnosed?
Atrial fibrillation is diagnosed by a test called an electrocardiogram or ECG. The test records the electrical activity of the heart.

How Is AF treated?
Atrial fibrillation can be treated using medicines either to control the heart rate or the rhythm abnormality itself. In patients with risk factors for stroke (such as heart failure, diabetes, advanced age, prior stroke, vascular disease, or kidney problems) it is essential that prophylactic blood thinners are considered to reduce the risk of stroke.

The chances for successful treatment are higher when atrial fibrillation is paroxysmal. When atrial fibrillation becomes persistent, normal rhythm can often be restored using an electrical shock. However, this does not treat the underlying triggers and substrate for atrial fibrillation and the rhythm abnormality typically recurs. Another procedure, which is increasingly used, targets the underlying triggers and substrate for atrial fibrillation by catheters that heat or freeze the abnormal heart tissue thus rendering it non-conductive and unable to cause atrial fibrillation. In rare cases, pacemaker implantation or surgical interventions can also be used to control atrial fibrillation.

Atrial fibrillation is mechanistically related to high blood pressure, alcohol intake, thyroid hormone imbalanace, sleep apnea, and coronary and other heart diseases. Therefore, treatment and control of these underlying factors can be very effective for control of atrial fibrillation.

Support – Where can patients find info about support groups or local resources?
Johns Hopkins Medicine: Heart and Vascular Institute
stopafib.org: Resources for Atrial Fibrillation Patients and Caregivers
UPMC: Heart and Vascular Institute
Penn State Milton S. Hershey Medical Center: Penn State Hershey Heart and Vascular Institute
American Heart Association: Atrial Fibrillation Resources
Mended Hearts: Inspiring hope and improving the quality of life for heart patients and their families through ongoing peer-to-peer support.
Temple Health: Temple Heart & Vascular Institute

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