Atrial Fibrillation

 

What is atrial fibrillation?

Atrial fibrillation (AF) is a heart rhythm where the upper chambers of the heart (called the atria) move very fast and may cause the lower chambers of the heart to also beat fast. Your provider may describe this condition as having "an irregular heart rhythm". It is also very common in patients with heart failure as the heart becomes enlarged. It is also very common in people over the age of 80 years. When a person has AF, there is less blood being pumped out of the heart to the organs. This leads to symptoms.

What are the symptoms of AF?

• shortness of breath
• palpitations (feeling like your heart is jumping)
• fainting or feeling like you are going to faint
• dizziness
• chest pain or pressure

What are the risks associated with AF?

People with AF are at risk for having a stroke. Since less blood is getting pumped out of the heart this means more blood is staying inside the heart. Blood can swirl around in the atria (upper chambers of the heart) and form a blood clot. This blood clot can travel and cause a stroke. To prevent a clot, your doctor may prescribe a blood thinner.

You may be started on warfarin (Coumadin) or dabigatran (Pradaxa).

Your doctor needs to know about all other medicines you are taking or start while taking these medications. Ask your doctor before starting any over-the-counter meds or herbal products if you are taking any prescription drugs.

What are the common causes of AF?

• High blood pressure
• Heart failure
• Acute infections, especially pneumonia
• Electrolyte imbalances
• Lung cancer
• Pulmonary embolism
• Sleep apnea
• Overexertion
• Dehydration
• After a surgery or procedures

What are the types of AF?

There are three types of AF and your treatment will depend on the type of AF that you have:

• Paroxysmal: AF starts and stops on its own and may occur for just a short time.
• Persistent: AF is continuous and does not stop it but may be changed to a normal rhythm by medical or electrical treatments.
• Permanent: AF is continuous and cannot be changed to a normal rhythm by medical or electrical treatments.

Other than a blood thinner, what are the treatments for AF?

Treatment will depend on the kind of AF that you have, what type of symptoms you are having, and your how you feel when you are in AF.

There are two common treatments:

• Control the heart rate (slowing the heart rate down). Heart rate control means that patients are left in AF but the heart rate is slowed down (goal of 50-70 bpm usually) to allow the upper and lower chambers more time to fill and pump more blood out of the heart with each beat. This is done by certain medications such as beta blockers, calcium channel blockers, and/or digoxin (lanoxin).>
• Control the heart rhythm (by getting you out of AF). Heart rhythm control means that attempts are made to convert the heart back into a normal rhythm. This is done through certain drugs such as dofetilide (Tikosyn), amiodarone (Pacerone), dronedarone (Multaq), sotolol (Betapace), flecainide (Tambocor), rhythmol (Propafenone) or diltiazem (Cardizem).

What are the Surgical Treatments for AF?

Surgical treatment for AF is considered when:

• Treatment does not control or correct AF and You are still having symptoms
• Meds for AF cause more harm than good
• Blood thinners cannot be taken
• Blood clots or a stroke occurs

Surgical treatments may include an atrial fibrillation ablation, an A-V nodal ablation, a "Maze" procedure or a "mini-Maze" (pulmonary vein isolation) procedure.