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Atrial Fibrillation

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What is Atrial Fibrillation?

Atrial Fibrillation Cardiogram

Atrial fibrillation (AF) is a type of heart rhythm disorder where the atria (upper portion of the heart) beats chaotically or irregularly, becoming out of sync with the ventricles (lower portion of the heart), preventing the heart from pumping blood effectively. This results in abnormal and very rapid heartbeats, which, in turn, lead to the pooling of blood in the upper chambers of the heart. This causes blood clots that increase one’s risk of stroke.

Atrial fibrillation can sometimes show no symptoms, but it is often known to cause weakness or difficulty breathing. In addition, it may result in fast or pounding heartbeats, more commonly known as heart palpitations.

What are the types of Atrial Fibrillation?

The types of AFib are:

1.   Paroxysmal AF

This refers to AF that comes and goes. These episodes may last for as short as seconds to several days. In these cases, the heart beats may switch from a slow to a fast rhythm and back again in short periods of time. 

Patients who suffer from this form of AF often experience more symptoms than others. 

2.   Persistent AF

As the name suggests, Persistent AF happens consistently and will not stop without the help of medication or electric shock (cardioversion) to help restore the heart’s normal rhythm. 

3.   Long-standing persistent AF

Formerly known as Permanent AF, this refers to AF that cannot be corrected, even with the use of medication and cardioversion.

How is Atrial Fibrillation caused?

AFib occurs when the atria beat irregularly and out of sync with the ventricles of the heart. This is most often caused by structural problems in the atria. Other heart-related causes of AFib include:

  • Coronary artery disease
  • Heart failure
  • High blood pressure
  • Heart valve disease
  • Sick sinus syndrome
  • Congenital heart defects
  • Prior heart surgery

Sometimes, AFib can be caused by other problems that are unrelated to the heart. Some examples are:

  • Sleep apnea
  • Thyroid disease
  • Lung disease or cancer
  • Infection
  • Use of stimulants like alcohol, caffeine, or tobacco

Who is more likely to suffer from Atrial Fibrillation?

Some people are more prone to developing AFib than others. Risk factors for AFib include:

  • Advanced age
  • Existing heart diseases
  • High blood pressure
  • Diabetes
  • Obesity
  • Excessive alcohol consumption
  • Smoking
  • Family history of AFib
  • Other chronic conditions

What are the symptoms of Atrial Fibrillation?

Some common signs and symptoms of AFib are:

However, it is important to note that these differ from person to person, and some people may not experience any symptoms at all. Consult your cardiologist immediately if you suffer from the aforementioned symptoms. 

When should I go to a doctor?

You should see a doctor if you are experiencing any of the symptoms of AFib, especially chest pain. During your first consultation, your doctor will perform a physical examination and ask you about any symptoms you’ve experienced. They will also obtain a detailed review of your medical history and family history. 

If necessary, your doctor may order one or more diagnostic tests to determine the extent of your condition and the best course of treatment. These tests include:

These tests allow your doctor to check for an irregular heartbeat and to help them figure out what is causing these irregularities and the best way to treat them. 

What are the treatments for Atrial Fibrillation?

Pulmonary vein isolation (PVI) is a type of catheter ablation procedure performed to treat atrial fibrillation (A-fib).

Depending on the cause and extent of your AF, treatment for your condition may come in several forms, from medication to surgery and the use of implants. 

1.   Medications

Some medications used to treat AF include rhythm control medications, drugs to slow the heartbeat, and antiplatelets to prevent the formation of blood clots and thus reduce the likelihood of stroke.

2.   Cardioversion

Cardioversion helps restore the erratic or abnormal heartbeats to a normal sinus rhythm. Cardioversion therapy can be carried out in two ways:

  • Electrical cardioversion –This method involves the use of high-energy shock transmitted to the heart via paddles or patches placed on the chest.
  • Drug cardioversion – Also known as pharmacologic or chemical cardioversion, medication is administered orally or intravenously (IV) to restore the heart rhythm.

It is important to properly diagnose the condition properly and determine the underlying cause of the problem in order to discern the best course of treatment for the patient.

3.   Therapeutic procedures

When medication is insufficient in treating AF or a patient is having intolerable side effects from medicines, your doctor may advise you of procedures like catheter ablation (pulmonary vein isolation). 

Catheter ablation, also known as cardiac ablation, uses heat or cold energy to create tiny scars in small areas of the heart tissues that are responsible for rhythm problems. As the name suggests, catheter ablation is done by inserting a thin, flexible tube called a catheter through a tiny incision in your groin area into your heart. 

4.   Surgery

In extreme or complex cases, surgical intervention may be needed to effectively treat AFib and restore sinus rhythm. The surgical procedure most often used in such cases is known as the Maze procedure. During this procedure, incisions are made in the atria to prevent any abnormal electrical impulses from affecting it.

In addition to these treatments, your doctor may also prescribe certain lifestyle changes to improve your overall heart health like quitting smoking, reducing your alcohol consumption and changing your diet. 

It is important to properly diagnose the condition properly and determine the underlying cause of the problem in order to discern the best course of treatment for the patient. 

Are there any complications that arise from untreated Atrial Fibrillation?

One of the most dangerous complications that can arise from untreated AF is stroke. Due to the irregular heartbeat characteristic of AF, blood is unable to be pumped normally and becomes more likely to clot in the atria. If any blood clots are pumped out of the heart and travel to the brain, a stroke will occur. Conversely, blood clots that travel to the lungs put the patient at risk of a pulmonary embolism

Certain health conditions may exacerbate your likelihood of developing a stroke due to AF, including high blood pressure and diabetes.

When left untreated for extended periods of time, AF is also likely to result in heart failure. This refers to a condition where the heart does not pump blood as efficiently as it should.

Summary

While some people can live a normal life with atrial fibrillation, it has also been known to cause dangerous complications when left untreated. As such, you should visit a doctor as early as possible if you suspect that you have AF, or are experiencing any of its symptoms. 

As with other heart-related conditions, leading a healthy lifestyle can also reduce your risk of developing any heart disease and may prevent AFib. Some suggestions for doing this include:

  • Eat a heart-healthy diet
  • Exercise regularly
  • Reduce stress levels
  • Reduce alcohol and caffeine consumption
  • Stop smoking, if you are a smoker

If you would like more advice on how to maintain a healthy heart, please do not hesitate to see a cardiologist who will be able to detect any possible problems early, as well as help you to keep your heart as healthy as possible.

Dr Devinder Singh

Senior Consultant Cardiologist &
Cardiac Electrophysiologist

Dr Devinder Singh is the Medical Director of Cadence Heart Centre. He is an experienced Senior Consultant Cardiologist & Cardiac Electrophysiologist with over 20 years of clinical experience.

His expertise lies in clinical cardiology, cardiac rhythm disorders (arrhythmia), cardiac pacing (including cardiac resynchronisation therapy) and cardiac magnetic resonance imaging. He performs electrophysiology studies and radiofrequency ablation of cardiac arrhythmias, and is well versed in pacemaker and defibrillator insertions.

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