Atrial Fibrillation

When the upper chambers of the heart (atria) beat in a fast and irregular rhythm (fibrillation) the condition is called atrial fibrillation (A Fib). Because the electrical impulses are so fast and chaotic, the atria cannot contract and move blood effectively into the ventricle. The quivering atria can lead to blood pooling. This increases the risk of forming blood clots. These clots can then travel to the brain, and cause a stroke. This is why A Fib significantly increases the risk for stroke.

Causes of Atrial Fibrillation

Atrial fibrillation is the most common of all arrhythmias. According to the Heart Rhythm SocietyOff Site Icon, age is one of the most common risk factors. People over the age of 60 are at a greater risk of developing cardiovascular conditions, including heart arrhythmias. There are other risk factors, as well:

People who have had heart attacks or have recently had surgery are also at a higher risk for atrial fibrillation. Talk to your doctor to learn more about your risk for developing atrial fibrillation.

Symptoms of A Fib

People experience atrial fibrillation differently; some people may have no symptoms at all. More commonly, however, people will feel the effects of atrial fibrillation, which impairs the heart’s ability to deliver oxygenated blood throughout the body.

General fatigue is the most common symptom of A Fib, and feeling tired may be the only clue a person has about an abnormal heart rhythm. In addition to fatigue, the American Heart AssociationOff Site Icon(AHA) identifies the following symptoms of atrial fibrillation:

  • Anxiety
  • Chest pain or pressure
  • Confusion
  • Dizziness
  • Fainting
  • Fatigue during exercise or activity
  • Fluttering or “thumping” in the chest
  • Rapid and irregular heart beat
  • Shortness of breath
  • Sweating
  • Weakness

Because chest pain may also be a symptom of a cardiac emergency, such as heart attack, Premier Health and the American Heart Association warns those who experience chest pain to call 911 immediately.

To learn more about the symptoms of atrial fibrillation, talk to your health care provider.

How is Atrial Fibrillation Diagnosed?

According to the 2005 Atrial Fibrillation Follow-up Investigation of Rhythm ManagementOff Site Icon(AFFIRM) study, 12% of the study population experienced no symptoms of atrial fibrillation. Because no symptoms prompt a doctor visit, people with asymptomatic A Fib are diagnosed by chance, if they are diagnosed at all. In other words, their healthcare provider finds the abnormal heart rhythm during a routine check-up or during a visit for other complaints. Once the arrhythmia is discovered or suspected, the healthcare provider may refer to a specialist for further testing. Diagnostic tests used to confirm atrial fibrillation include:

  • Electrocardiogram (EKG/ECG): Electrodes are placed on the skin to record the heart’s electrical activity
  • Holter monitoring: A patient wears a Holter monitor, a portable ECG device, that records heart activity for 24 to 48 hours and their heart’s electrical activity is recorded
  • Event recording: A patient wears an event recorder, which is similar to a Holter monitor but is worn for a longer period of time and automatically activates when an arrhythmic episode begins (Event recording is necessary for patients with paroxysmal atrial fibrillation who experience intermittent abnormal heart rhythms)

Because asymptomatic atrial fibrillation may only be discovered during a routine exam, it is important to get regular checkups. Ask your doctor about atrial fibrillation at your next health physical.

Dangers of A Fib

Some individuals live for years with atrial fibrillation without problems. While intermittent A Fib itself is not harmful, the heart’s inability to pump blood properly presents serious health risks.

During A Fib, the upper chambers can beat so fast (100 to 300 beats per minute) they quiver. If the heart muscle does not fully relax or contract, blood will not be effectively pumped from the atria to the lower chambers of the heart. As a result, blood can pool and clot in a thin, sack-like structure attached to the heart called the left atrial appendage (LAA). If a clot is pumped out of the heart, it can travel to other parts of the body, and if the clot goes to the head, a stroke may occur.

According to StopAfib.orgOff Site Icon, the risk of stroke increases five-fold for people with atrial fibrillation. StopAfib.org also reports that one-third of patients with atrial fibrillation will actually experience a stroke. Other studies show that the prognosis for people with A Fib who suffer a stroke is poor; patients are more likely to suffer long-term disability and require constant nursing care.

The irregularity of the heart’s pumping ability may make the heart to work less efficiently. When atrial fibrillation occurs over a long period of time the heart may be weakened and lead to heart failure.

To learn more about complications of atrial fibrillation and how to manage your risks, talk to your doctor.

Treating Atrial Fibrillation

When it comes to treating A Fib, both the National Institute of Health’s National Heart, Lung and Blood InstituteOff Site Icon (NHLBI) and the American Heart Association (AHA) agree that the goals of treatment are:

  • Preventing blood clots and managing other risk factors for stroke
  • Reducing the number of times per minute the ventricles contract (rate control)
  • Restoring a normal heart rhythm (in the atria and ventricles)
  • Treating any underlying condition that contributes to atrial fibrillation, such as hyperthyroidism and diabetes

Doctors may use medications to lower the heart rate and prevent blood clots. Medications used for rate control include beta blockers, calcium channel blockers, and digitalis. Common blood thinners for stroke prevention include aspirin, heparin, and warfarin.

There are new medications and procedures available to help manage the risks of stroke and bleeding in patients with atrial fibrillation. Premier Health was the first to bring another option to Dayton for those patients considered suitable to use warfarin by their physicians, but have reason to find an alternative. It’s called the WATCHMAN™ Left Atrial Appendage Closure (LAAC) Device. No larger than a quarter, it is implanted in the heart’s left atrial appendage (LAA), permanently closes off the small pouch, and thereby reduces the risk of stroke. Over time, patients may be able to stop taking their warfarin medication. Implanting the WATCHMAN Device is a one-time procedure, but not all patients are candidates. Please discuss eligibility and treatment options with your physician.

Doctors may recommend other options to treat patients who have recently experienced atrial fibrillation and/or those who do not respond well to rate control medications. Other options include:

Atrial fibrillation may be caused or exacerbated by other conditions. To manage those health conditions and/or reduce risks, doctors may also recommend lifestyle changes, such as:

  • Eating a balanced diet
  • Reducing caffeine and/or salt intake
  • Exercising
  • Managing stress
  • Quitting smoking

Talk to your doctor to find out how your atrial fibrillation may best be treated.

Physician Videos: All about A Fib

Watch our physician answer frequently asked questions about atrial fibrillation and learn more.

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Content Updated: July 18, 2018

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