Atrial Fibrillation refers to abnormal heart rhythm which affects the flow of blood in the body. The word ‘Fibrillation’ relates to the palpitating nature of heart muscles in the atria. In atrial fibrillation the heart rate might extend from 100 to 175 beats per minute while the normal beat is 60 to 100 per minute. It is described as the most common form of arrhythmia.
The human heart works with the help of two upper chambers called atria and two lower chambers called the ventricles. The sinus node is present in the upper right chamber of the heart. This node is responsible for the formation of normal electrical impulses. At the stage of atrial fibrillation these impulses are eclipsed by disordered electrical impulses arising in the atria and the pulmonary veins. As a result unmethodical impulses are sent to the ventricles producing an irregular heartbeat that might proceed from minutes to weeks or years. Though atrial fibrillation is not life- threatening, it leaves a place for congestive heart failure or heart stroke, palpitations, chest pain and fainting. The risk of getting this abnormality in rhythm can be observed in people above 80 years of age.
Atrial Fibrillation is often irregular in nature. It might not be identified at any early stage. However the disease might occur in three stages.
Paroxysmal Atrial Fibrillation: In paroxysmal, the heart rate becomes rapid but might disappear on its own. The period lasts for seconds, minutes or 7 days without treatment.
Persistent Atrial Fibrillation: In persistent condition, the abnormal heart beat continues till it is treated. This might last longer than a week or less with treatment.
Longstanding Persistent Atrial Fibrillation: A stage where the irregularity might persist for more than a year and need special treatment.
Occasional Atrial Fibrillation does not occur with any symptoms. It might go on for minutes or hours and stop voluntarily. In chronic cases the following symptoms are generally observed.
- Chest pain
- Shortness of breath
- Low blood pressure
- Palpitations, a feeling of irregular heart beat
Abnormal signals passing in a rapid and disorganized manner through the heart results in atrial fibrillation. Some minor causes include hyperthyroidism, pulmonary embolism, pneumonia and use of alcohol. Commonly, atrial fibrillation is associated with cardiac diseases. Heart valve disease and coronary heart disease might result in arrhythmic heart beat. Left ventricular hypertrophy and hypertension can also cause rapid heartbeat. Non- functioning SA node may produce improper impulses. Sometimes fibrillation can be caused by Emphysema or other lung diseases and metabolic imbalance. In case of lone atrial fibrillation the heart rhythm is quite normal but patients may experience episodes of arrhythmia.
Electrocardiogram(EKG): The basic level test to check the irregular beats of the heart in case of atrial fibrillation is EKG. The recorded waves give a clear picture of the electrical impulses.
Echocardiogram: An ultra sound test where sound waves are sent into the heart with the help transducer which produces video images of the heart and its movement.
Transesophageal Echocardiogram: It produces pictures of the heart through the esophagus to test blood clots in the heart.
Event recorders: Event recorders are used in checking the arrhythmic beats of the heart.
Holter monitor: The device records electrical impulses of the heart.
Blood tests: A complete blood cell count test can be conducted to check the body’s electrolytes.
Thyroid test: A thyroid test checks the presence of hyperthyroidism which may be the root cause for atrial fibrillation.
Chest X-ray: The size of the heart and position of the lungs can be analyzed with the help of an X-ray.
Stress Test: A diagnosis that checks the heartbeat while exercising.
The treatment for atrial fibrillation focuses on two aspects – correcting the arrhythmic beats of the heart and preventing blood clots. Diagnosis at an early stage can restore the rhythm to normal in 24 to 46 hours. Anti-arrhythmic medications can be given to patients at the earliest to bring the regular rhythm of the sinus node. In some cases Defibrillation (cardioversion) is suggested where electrical shocks are sent to the heart to regularize the electric activity of the heart. Medications like Amiodarone, Dronedarone, Propafenone, Sotalol are prescribed after cardioversion. In cases where medications prove to be ineffective atrioventricular node ablation is suggested to patients. The procedure involves preventing electrical impulses from the atria to the ventricles. Blood thinning medications are still to be continued after this to escape the risk of heart stroke.
In cases of severity, medications and cardioversion may not be helpful. Such conditions demand procedures to destroy the heart tissue causing abnormal electrical signals and bring the heart to normal. Radiofrequency catheter ablation and surgical maze procedure are other options to control atrial fibrillation.
The treatment for atrial fibrillation is associated with the risk of blood clots that might lead to a heart stroke. However the dosage of Warfarin and Dabigatran to prevent blood clots need to be monitored. The patient might be advised to take medications for blood clots as well as treating irregular beats of the heart.
The treatment is quite expensive which involve highly experienced surgeons to prescribe medications or surgery to patients with fibrillation.
Atrial fibrillation may sometimes turn out to be more complicated. Due to abnormal rhythm, blood might get clotted in the upper chambers of the heart resulting to a stroke. Factors like age, high range of blood pressure, diabetes, heart failure contribute to the stroke in atrial fibrillation.
Atrial fibrillation can be prevented by changing one’s lifestyle and dietary habits. Alcohol and caffeine or nicotine need to be avoided. Proper checking of high blood pressure and managing stress would reduce the risk of heart diseases. Walking would be the most suitable exercise to acquire a healthy heart. Usage of antibiotics also needs attention. A regular check up of heartbeat from time to time would help in preventing spells of atrial fibrillation.
Consumption of less salt, healthy diet for the heart and physical exercise improves the condition of the heart leaving it free from fibrillation.