Atrial fibrillation is a fast and very irregular heart rhythm. While atrial fibrillation (AFib) is not itself life-threatening, it often causes significant symptoms, including palpitations, shortness of breath, and easily becoming fatigued. It can lead to more serious problems, especially stroke, and—in people with heart disease—worsening heart failure.
Several treatment options are available for fibrillation , but choosing the simplest one isn’t always straightforward. If you’ve got AFib, you ought to attempt to learn everything you’ll about this arrhythmia so you’ll work together with your doctor to make a decision which therapeutic approach is true for you.
What Happens With AFib
Atrial fibrillation may be a fast and really irregular cardiac rhythm caused by extremely rapid and chaotic electrical impulses originating within the heart’s atria (the two upper cardiac chambers). this type of rapid, chaotic electrical activity within the heart is named fibrillation.
When the atria begin fibrillating, three things can happen:
The heart rate tends to become rapid and irregular. The AV node is bombarded with frequent, irregular electrical impulses coming from the atria. Many of those impulses—as many as 200 per minute or more—are transmitted to the ventricles. This leads to a quick and really irregular heartbeat and disturbing symptoms.
When the atria are fibrillating, they’re not beating effectively. therefore the normal coordination between the atria and therefore the ventricles is lost. As a result, the guts works less efficiently and eventually may begin to fail.
Because the atria are not any longer contracting effectively, after a time (usually after about 24 hours or so), blood clots can begin to make there. These blood clots can eventually break off and visit various parts of the body, like the brain.
While fibrillation itself often produces significant symptoms, its real significance is that it puts you in danger for medical conditions which will be permanently disabling or fatal.
Atrial Fibrillation Symptoms
The arrhythmia tends to be very noticeable, and most of the people with fibrillation experience significant symptoms. the foremost common symptoms are palpitations, which are usually perceived as feeling a rapid, irregular heartbeat, or perhaps as “skipped” beats.
People with fibrillation also commonly experience easy fatiguability, shortness of breath, and (occasionally) light-headedness. These symptoms, directly associated with the fibrillation itself, can often be particularly impactful in people that have diastolic dysfunction, or cardiomyopathy .
However, fibrillation can occur without producing any symptoms in the least . While that’s good thing, having “silent” fibrillation can still produce medical problems. It can cause more frequent or intense angina in people that have arteria coronaria disease (CAD) or a considerable deterioration in cardiac function in people with coronary failure .
In fact, if a really rapid pulse caused by fibrillation persists for a minimum of several months, the guts muscle can begin to weaken and coronary failure can occur—even in people whose hearts are otherwise normal.
The most dire consequence of fibrillation , however, is that the possibility of stroke. Untreated fibrillation substantially increases one’s risk. As many as 15% of all strokes are thought to be caused by AFib. Furthermore, many of us who have suffered strokes for no apparent reason (so-called cryptogenic strokes) end up to possess episodes of “silent” fibrillation .
Atrial fibrillation are often produced by several cardiac conditions, including CAD, mitral regurgitation, chronic hypertension, pericarditis, coronary failure , or virtually the other quite heart problem. This arrhythmia is additionally fairly common with hyperthyroidism, pneumonia, or pulmonary embolus.
Ingestion of amphetamines or other stimulants (such as cold remedies containing pseudoephedrine) can cause fibrillation in some people, as can drinking as few together or two alcoholic beverages—a condition referred to as “holiday heart.” While doctors have traditionally said caffeine also causes fibrillation , evidence from newer clinical studies shows that, in most of the people , it doesn’t .
A large proportion of individuals with fibrillation haven’t any particular identifiable reason for it. This, called idiopathic fibrillation , is usually a condition related to aging. While fibrillation is rare in patients under 50, it’s quite common in people that are 80 or 90 years old.
Newer studies have shown that fibrillation is said to lifestyle in many cases. as an example , people that are overweight and sedentary have a way higher risk of fibrillation . In people that have fibrillation associated with lifestyle choices, an intensive program of lifestyle modification has been shown to assist eliminate the arrhythmia.
The diagnosis of fibrillation is typically straightforward. It simply requires recording an electrocardiogram (ECG) during an episode of fibrillation . This requirement doesn’t present a drag in people with chronic or persistent fibrillation , in whom the arrhythmia is probably going to be seen any time an ECG is taken.
However, in people whose fibrillation occurs intermittently, long-term ambulatory ECG monitoring could also be required to form the diagnosis. this might be especially useful in people that have had cryptogenic strokes, since treating fibrillation (if it’s present) may help prevent recurrent stroke.
Doctors classify fibrillation into differing types . In fact, several confusing classification systems for fibrillation are used. to assist you opt which treatment approach is true for you, it’s useful to lump the kinds of fibrillation into only two groups:
New onset or intermittent atrial fibrillation: Here, fibrillation is either a brand-new problem or one that happens only intermittently. Intermittent fibrillation is usually called paroxysmal fibrillation . People during this category have a traditional cardiac rhythm the overwhelming majority of the time, and their episodes of fibrillation tend to be relatively brief and typically infrequent.
Chronic or persistent atrial fibrillation: Here, fibrillation is either present all the time or occurs so often that periods of normal cardiac rhythm are relatively infrequent or short-lived.
If it were very easy and really safe to try to to so, it seems obvious that the simplest treatment for fibrillation would be to revive and maintain the traditional cardiac rhythm . Unfortunately, in many cases, it’s neither particularly safe nor easy.
Especially if fibrillation has been present for weeks or months, it’s exceedingly difficult to take care of a traditional rhythm for quite a couple of hours or days. This unfortunate fact has required two different general treatment approaches for atrial fibrillation:
The rhythm control approach attempts to revive and maintain a traditional cardiac rhythm . it’s more likely to figure in people with recent-onset or intermittent fibrillation , and far less likely to be effective in people whose arrhythmia is chronic or persistent. The rhythm control method usually requires either the utilization of antiarrhythmic drugs, ablation therapy, or both.
The rate control approach abandons the plan to restore and maintain a traditional cardiac rhythm . fibrillation is accepted because the new “normal” cardiac rhythm , and therapy is aimed toward controlling the guts rate so as to attenuate any symptoms being caused by the fibrillation . Treatments include pulse control medications like digitalis, beta-blockers, and calcium channel blockers.
Long-term studies have shown that clinical outcomes with the rate-control approach tend to be a minimum of as favorable because the rhythm-control approach.
Whichever therapeutic approach is chosen, a crucial additional feature of treating fibrillation is to require the required steps to attenuate the danger of stroke. This usually requires taking anticoagulant drugs, but there are other treatment alternatives also , including surgery or a catheter procedure to isolate the left atrial appendage (a “pouch” of the left atrium of the heart that’s left over from fetal development).
Lifestyle changes are a crucial component of treatment, aimed toward reducing both symptoms and risks of stroke or heart condition .