Atrial Fibrillation

Atrial FibrillationWe know that our hearts are essentially pumps, pushing blood throughout the body. But did you know that your heart also generates its own electricity? Well, it does!

The heart is divided into four chambers, or sections. Each of the top chambers is called an atrium, while each of the lower ones is called a ventricle. The heart’s electrical signals (called impulses) are generated in a tiny area of the right atrium called the SA Node (sinoatrial node) and spread across to the left atrium. This makes the muscles of the heart contract, which pushes the blood into the left and right ventricles. The ventricles then push blood out to the rest of the body.

A healthy heart beats at a regular rhythm (about 60-70 times per minute when you’re resting). But sometimes the SA node doesn’t “fire” in rhythm. When that happens, the heart beats irregularly—a condition called arrhythmia. Arrhythmia can be continuous, or it can come and go.

The most common type of persistent (continuous) arrhythmia is Atrial Fibrillation (AFib).

About

WHAT HAPPENS IN THE HEART WHEN YOU HAVE AFIB?  

When you have AFib, your heart’s electrical impulses don’t start in the SA node. Instead, they start in another part of the heart and cause the atria (top chambers) to beat too quickly and irregularly. This prevents blood from being pumped effectively into your ventricles (the lower chambers). 

HOW AFIB CAN LEAD TO STROKES? 

The biggest concern you have with AFib is the risk of stroke.  When your blood isn’t effectively pumped into the left ventricle, the blood may pool in your heart and form solid clumps called blood clots.  These blood clots may break loose and start traveling throughout your arteries. If they partially (or fully) block blood flow to your brain, brain cells will start dying, and this causes a stroke.

  • AFib increases your risk of stroke by nearly 5 times.
  • Strokes that occur in people who have AFib are usually more severe and are about twice as likely to be fatal or lead to a severe disability.
  • In the United States, every 12 seconds, someone has a stroke related to AFib.

A stroke is of serious concern because it can cause blindness, difficulty walking and talking, paralysis, permanent disability, or death, and the damage is usually irreversible.

Your risk of developing a stroke is even greater if you smoke or have other conditions such as obesity, high cholesterol, high blood pressure, or heart disease . Getting plenty of physical activity can decrease your stroke risk. But, if you’ve had a stroke, it often leaves you too weak to get up and exercise (or even walk).

If you have any symptoms of atrial fibrillation, make sure you contact your healthcare provider immediately.

WHAT ARE RISK FACTORS FOR DEVELOPING AFIB?

  • Age: The older you are, the greater your risk.
  • Family history: An increased risk of atrial fibrillation may be genetic.
  • Diabetes: If you do not have well controlled blood sugar level, you are at risk.
  • High blood pressure: This is one of the most common causes of AFib.
  • Smoking
  • Excessive alcohol or caffeine use
  • Stress
  • Diseases that affect the health of the heart, including:
    • Coronary heart disease. Anyone with heart disease, including valve problems and a history of heart attack and heart surgery, has an increased risk of AFib.
    • Chronic lung disease
    • Congestive heart failure
    • Cardiomyopathy (disease of heart muscle that causes heart failure)
    • Congenital (present at birth) heart disease
    • Pulmonary embolism (blood clot in lungs)

AFib and Sexual Health

Some people may be hesitant to “over exert” themselves with normal sexual activity, there really is no reason to stop. As long as you are cleared for normal activity by your healthcare provider then there is no reason to change anything in your sex life. Refraining from sex could cause unnecessary stress and tension in your life/relationship. You should pay attention to anything that may not feel right during sex, like pain, numbness or erectile dysfunction and alert your healthcare provider immediately for a checkup.

FYI

AFib affects more than 5.1 million people in the U.S. today—and experts expect that number to reach nearly 12 million by 2050.

Symptoms

Some people may have no symptoms at all. Others may notice one or more of the following:

  • Racing, irregular heartbeat
  • Heart palpitations (feelings that your heart is skipping a beat, fluttering)
  • Shortness of breath especially when exercising
  • Weakness
  • Chest pain (angina)
  • Dizziness or fainting
  • Fatigue (tiredness)
  • Confusion
  • Sweating

Prevention

The best way to reduce your risk of developing AFib is by leading a healthy lifestyle. Here are some tips to help you:

  • Get regular physical activity, at least 3 times per week.
  • Eat a heart-healthy diet, low in saturated fats, trans fats, sodium and cholesterol
  • Manage high blood pressure and take medication as recommended by your healthcare provider.
  • Drink alcohol and caffeine in moderation
  • If you smoke, quit smoking

WHEN TO TALK TO YOUR HEALTHCARE PROVIDER ABOUT AFIB: 

  • AFib is a disease with serious consequences so anytime you feel a difference in your symptoms or response to your medication; speak to your healthcare provider.
  • Tell your healthcare provider all the symptoms you have and when you had them. This includes any that may seem unrelated to AFib.
  • Make a list of all medications, as well as any vitamins or supplements that you’re taking.
  • Try to keep a journal and jot down everything so you don’t forget to tell your healthcare provider.

Diagnosis

Physical Exam

  • A complete cardiac exam. This will include listening to the rate and rhythm of your heartbeat and taking your pulse and blood pressure reading.
  • Your healthcare provider will likely check for any signs of heart failure, and other symptoms of heart problems, such as swelling in your legs or feet.  

Medical and Family Histories

Your healthcare provider will likely ask you questions such as:

  • What symptoms are you having? Are your feet or ankles swollen? (this is a possible sign of heart failure) Do you have any chest pain?
  • Do you have other health problems, such as a history of heart disease, high blood pressure, lung disease, diabetes, or thyroid problems?
  • Does anyone in your family have a history of AFib? Has anyone in your family ever had heart disease or high blood pressure? Has anyone had thyroid problems? Does your family have a history of other illnesses or health problems?
  • Do you smoke or are you a heavy user of alcohol or caffeine?

Electrocardiogram (EKG):

  • An EKG is the most useful test for diagnosing AFib. It’s a simple, painless way of recording how fast your heart is beating and its rhythm (steady or irregular). It also records the strength and timing of electrical signals as they pass through your heart. Depending on the frequency of your AFib episodes, your healthcare provider may ask you to wear a portable EKG monitor at home (called a Holter monitor) in order to record your heart’s rhythm over a longer period (usually 24 to 48 hours).
  • Your healthcare provider may also order a blood test, chest X-ray, or echocardiogram (a test that shows your heart in motion) to look for the underlying cause of your AFib as well as any signs of complications.

Questions to Ask Your Health Care Provider

  • How serious is my AFib?
  • What are my treatment options?
  • What changes do I need to make in my lifestyle including diet modification and physical activity level?
  • How often should I be screened for heart disease or other complications of AFib?
  • If you have any other health conditions, remember to ask: How can I best manage them together?

Remember: Don’t hesitate to ask questions any time you don’t understand something. When it comes to your health, there’s no such thing as a stupid question.

Treatments

Once you have been diagnosed with AFib, your healthcare provider may need to take medical action to get your heart rhythm back to normal. This is called rhythm control. Rhythm control allows the atria and ventricles to work together to efficiently pump blood to the body. He or she may also prescribe medication to prevent strokes.

Treatment may include:

1.    Medications to control rhythm: These will help to slow down the rate of your heartbeat or manage your heart’s rhythm. Different types include:

  • Rate Controllers. These medications will help to slow your heart rate to return it to normal. They are usually prescribed to individuals who cannot engage in any physical activity.
  • Rhythm Controllers. These medications will help to return and maintain a normal heartbeat. They are usually given to people who recently have started having AFib.

 2.    Medications for prevention of stroke: 

  • Antiplatelets. These are sometimes referred to as blood thinners although they don’t really thin the blood. They are given to people with a low risk, to help prevent a stroke.
  • Anticoagulants. These will help to prevent the formation of blood clots and will reduce your risk of a stroke.

Remember to always take the prescribed doses of your medication—especially when consequences such as having a stroke are involved.

3.    Electrical Cardioversion: These are low-energy shocks given to your heart to return it to a normal rhythm.

4.    Radiofrequency Catheter Ablation: This is a procedure that is used to destroy abnormal tissue in the heart, which may be interfering with your heart’s electrical signals.  You will be given anesthetic drugs that will put you to sleep for this procedure. This is usually done when other treatments do not work.

Last modified: May 31, 2014