Atrial fibrillation (AFib) is the most common type of heart rhythm disorder in the United States and affects about 3 million Americans. It is a chaotic, abnormal rhythm of the upper chambers of the heart. The abnormal rhythm causes the heart to beat chaotically, which many patients find un-comforting.
More concerning, atrial fibrillation can allow blood to coagulate, forming a new clot inside the heart which could lead to a stroke.
The heart muscle may weaken over time if atrial fibrillation makes the heart beat very rapidly, but the heart muscle is not starved for blood and oxygen the way it is when a heart attack occurs.
Heart attack or AFib?
“A heart attack occurs when a blockage develops in one of the arteries that feeds the heart muscle,” said Michael Delaughter, MD, a cardiologist on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth. “The dying heart tissue, starved for blood flow and oxygen, causes pain until the blockage is corrected or the tissue dies.
Symptoms will vary from person to person, but many experience shortness of breath, fatigue, decreased stamina, or an irregular heart rhythm or pulse. More severe cases can cause chest pain, dizziness or even heart failure symptoms such as leg swelling or trouble breathing.
“The condition occurs in every age group, but becomes more common after age 60,” said Kevin Wheelan, MD, a cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas. “People suffering from AFib may not even know they have it.”
People who are overweight, have high blood pressure, sleep apnea and diabetes can increase risk of a-fib. Less commonly, thyroid disorders can cause atrial fibrillation. Caffeine typically does not lead to an atrial fibrillation episode, although overindulging in alcohol can.
“Depending on the type and severity of AFib, there are various ways to reverse or control it, ranging from medication and surgery to healthier diets and lifestyles — these are key to helping all types of heart disease,” Dr. Wheelan said.
“The one thing not to do about AFib is ignore it.” — Dr. Wheelan
First, since atrial fibrillation can cause a stroke, many patients are prescribed blood thinner medications (anticoagulants). These medications inhibit clot formation, although they increase the risk of bleeding. Finding the right balance requires a careful discussion with your doctor.
Medication and/or cardioversion
Second is the issue of atrial fibrillation itself. In general, patients who experience symptoms are offered medications or procedures to help them return to and stay in normal rhythm. Cardioversion is an electrical shock delivered to a sedated patient to return them to normal rhythm however it does not reduce the risk of a future episode.
Medications should be viewed as “suppressants” of atrial fibrillation. While they are being taken, patients are less likely to have an occurrence of atrial fibrillation however many have side effects that require periodic testing or make long term use problematic.
The most modern treatment for atrial fibrillation is ablation. In this procedure, a small catheter is advanced through the veins of the leg into the heart to freeze or burn (ablate) very specific areas of atrial tissue. If successful, an ablation procedure can restore normal rhythm without the use of heart rhythm medications.
Think you might be at risk for atrial fibrillation? Get the care you need today.