Atrial fibrillation – Causes, symptoms and treatment

Overview

Afib, or atrial fibrillation, is an irregular and frequently very rapid heart rhythm (arrhythmia) that can cause heart blood clots. Afib raises the risk of stroke, heart failure, and other heart-related complications.

Afib is the most prevalent clinical arrhythmia worldwide. According to estimates, it may impact up to 3 per cent of adults aged 20 and older. Afib risk increases with age, but sometimes it affects young people as well.

The heart may beat much faster than usual in people with Afib, and the heart may also have trouble effectively pumping blood throughout the body. Blood may pool or accumulate in the heart, which increases the risk of clots.

What is Atrial fibrillation?

The top chambers of the heart, beat erratically and chaotically during atrial fibrillation, out of sync with the lower chambers or ventricles. May not show any symptoms in many individuals. However, atrial fibrillation may result in palpitations, a quick, pounding heartbeat, loss of breath or weakness.

Atrial fibrillation episodes might be intermittent or recurrent. Even though Afib is typically not a life-threatening disease, it is a serious medical condition that needs to be adequately treated to avoid stroke.

An individual with atrial fibrillation may also experience atrial flutter, a related heart rhythm problem. Despite being a distinct arrhythmia, atrial flutter can be treated in a manner that is very similar to atrial fibrillation.

Types of Atrial fibrillation

Paroxysmal Atrial fibrillation

A paroxysm, or short episode, of atrial fibrillation, may occur. You might experience symptoms, or it might subside quickly. It typically ends in less than 24 hours or could go on for up to a week. Multiple episodes of paroxysmal Atrial fibrillation are possible. Your symptoms might subside or you might need medical attention.

Tachy-brady syndrome is the term used to describe Atrial fibrillation of this type that alternates with a slower-than-normal heartbeat.

Persistent Atrial fibrillation

You have persistent atrial fibrillation when the abnormal heart rhythm you experience lasts for longer than a week. You might require treatment to control your heartbeat, but it might ultimately return to normal on its own.

Long-term persistent Atrial fibrillation

Long-term persistent atrial fibrillation is called when abnormal heart rhythms continue for longer than a year without improving.

Permanent Atrial fibrillation

Even when you and your healthcare professionals have attempted to restore a normal heart rhythm with medications or other treatments, Atrial fibrillation can occasionally persist. Your Atrial fibrillation is currently regarded as irreversible. Atrial fibrillation can frequently progress from paroxysmal to persistent to long-term, particularly without treatment.

Causes of Atrial fibrillation

The sinoatrial node, a unique region of the right atrium, the top right chamber of the heart, is typically the place of the electrical signals that initiate the heart pump. The stimulus causes the left and right atriums to contract. As a result, blood is pumped to the ventricles, the heart’s bottom chambers. The electrical signal then continues to travel down the heart, signalling the ventricles to contract.

Unusual electrical signals in the upper chambers disrupt this regular process in atrial fibrillation. Your heart’s upper and lower chambers cannot cooperate to successfully pump blood because the unusual signals cause the higher chambers to contract irregularly.

Damage to the heart’s tissue or electrical communication can cause the heart’s regular pumping to speed up and become erratic. Other diseases like coronary heart disease and high blood pressure typically bring on this kind of heart damage. Atrial fibrillation, however, can also arise from other variables that alter the heart’s electrical signalling or change the heart tissue’s structure.

Symptoms of Atrial fibrillation

You might be curious as to how Atrial fibrillation feels. Some Afib patients don’t exhibit any signs. It relies on how quickly your ventricles are beating. You probably won’t sense anything if they’re beating at a normal or slightly faster rate. But you’ll start to experience signs if your ventricles begin to beat more quickly. These may consist of

1· Extreme fatigue

2· An irregular heartbeat

3· Dizziness or lightheadedness

4· Fainting (syncope)

5· Heart palpitations

6· Shortness of breath (dyspnea)

7· Chest pain (angina)

8· A feeling of butterflies 

If you experience symptoms, keep track of when they occur and notify your healthcare provider as soon as possible.

How does Atrial fibrillation affect the heart?

Two higher chambers, known as the atria, and two lower chambers, known as the ventricles, comprise the four chambers of the human heart.

Blood is pumped from the atria into the ventricles each time the heart beats, then from the ventricles around the body.

Each heartbeat moves downward from the top of the heart to the bottom. Electrical signals coordinate the blood flow between the heart’s chambers and control the rate at which the heart beats.

These electrical signals are distorted in an Atrial fibrillation patient, which causes the atria to quiver or twitch jerkily, known as arrhythmia.

During a heartbeat, the heart may not completely pump blood from the atria to the ventricles, and the blood flow does not always follow a usual rhythm.

Who does atrial fibrillation affect?

Atrial fibrillation commonly affects the following people

Older people

Although younger people can acquire Atrial fibrillation, especially if other risk factors are present, older people are more frequently affected by Atrial fibrillation than their younger counterparts. Certain types of Atrial fibrillation, like holiday heart syndrome, are more prevalent in young individuals who are otherwise healthy.

Obese or overweight 

Obese or overweight people are more likely to acquire Atrial fibrillation as well as a number of other health issues.

Athletes

Atrial fibrillation signs can occasionally be brought on by increased physical activity due to the strain. Exercise should be integrated into a person’s daily routine because it is a healthy habit. Before beginning a new exercise, programme or increasing the intensity of your current workouts, it is usually advised to consult your doctor or another healthcare professional.

Treatment of Atrial fibrillation

Doctors adjust Atrial fibrillation treatments to be appropriate for each patient’s age, lifestyle, heart health, and general health. Some people may only require medications to stabilise their heart rhythm, while others may require surgery. Doctors occasionally suggest a combination of treatments.

Medications

Prescription medicines can control a person’s heart rate, prevent clots from forming, and, for some people, normalise heart rhythm.

Managing heart rate

If a person has a high heart rate, lowering it will stop heart failure and possibly lessen atrial fibrillation symptoms.

Several medications can help by slowing signals that tell the heart to beat. These include

Beta-blockers like digoxin (Lanoxin), metoprolol (Lopressor), and atenolol (Tenormin), as well as calcium channel blockers like diltiazem (Cardizem), verapamil (Verelan), and others. Before taking any medication, ensure you consult your healthcare provider.

Avoiding clots

A physician may recommend blood thinners or anticoagulants. These drugs make it more difficult for blood to clot.

A person’s risk of bleeding can rise when taking blood-thinning medications. But for most people, especially those at risk for stroke, the advantages of avoiding blood clots exceed the disadvantages of bleeding.

The CHA2DS2-VASc score is a tool that doctors use to assess stroke risk and determine whether a patient would improve from taking blood thinners.

Direct-acting oral anticoagulants, such as apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Lixiana), and dabigatran (Pradaxa), as well as warfarin, which is less frequently used, are some examples of blood-thinning drugs.

Normalising heart rhythm

Using medication, doctors may attempt to restore the heart’s usual rhythm. Chemical or pharmaceutical cardioversion is the term for this procedure.

Anti-arrhythmic drugs can assist in bringing about a regular cardiac rhythm or sustaining a normal rhythm in people with Atrial fibrillation.

They consist of potassium channel blockers like amiodarone and sodium channel blockers like flecainide (Tambocor) (Pacerone). However, the majority of individuals still require blood-thinning medication even after their heart rhythm returns to normal.

Procedures

When a patient is scheduled for heart surgery due to another medical issue, doctors will occasionally advise surgical procedures in addition to medication. The surgical alternatives include the following

Electrical cardioversion

A surgeon will deliver a synchronised electric shock to the heart. This can restore the rhythm to its regular beat. They might conduct a transesophageal echocardiogram prior to cardioversion. Obtaining a picture of the heart requires inserting a scope down the throat.

A surgeon will perform this treatment to make sure there are no heart clots. A doctor will recommend anticoagulant medication for a few weeks if a clot is present in order to dissolve it. The clot will dissolve, after which cardioversion will be feasible.

Catheter ablation

This operation eliminates the tissue responsible for the erratic rhythm. If Atrial fibrillation recurs, the surgeon might have to repeat this operation.

Surgical ablation

A maze procedure is an open-heart surgery that allows surgeons to remove the heart tissue responsible for the irregular rhythm.

Pacemaker placement

This device gives the heart instructions to beat regularly. In some cases, a surgeon will remove the natural electrical system and implant a pacemaker in a patient with intermittent Atrial fibrillation. This enables the pacemaker to take over and ensure regular heartbeats.

Prevention of Atrial fibrillation

Choices for a healthy lifestyle can lower the chance of heart disease and possibly even stop Atrial fibrillation. Here are some fundamental recommendations for maintaining a healthy heart health

• Eat a balanced meal.
• Get frequent exercise and keep your weight in check.
• Avoid smoking
• Limit or stay away from booze and coffee
• Be mindful of your stress levels because they can lead to heart rhythm issues.

Risk factors of Atrial fibrillation

We are more susceptible to atrial fibrillation as we age. Our risk increases, particularly after age 65. In addition to getting older, high blood pressure poses a significant danger. Atrial fibrillation is the result of high blood pressure in 1 in 5 instances. Additionally, if you suffer from any of the following conditions, your chance of developing Atrial fibrillation increases

1· Obesity

2· Type 2 diabetes

3· Heart failure

4· Coronary artery disease

5· Congenital heart disease

6· Lung diseases, such as chronic obstructive pulmonary disease (COPD)

7· Sleep apnea

8· Hyperthyroidism

In addition, certain lifestyle factors like smoking, recreational drug use and alcohol consumption can raise your risk of developing atrial fibrillation. However, obesity, inactivity, excessive alcohol use, and cigarette use are the four main risk factors for Afib that we can alter. Here are some recommendations to reduce your risk

• Eat heart-healthy foods.
• Exercise aerobically as part of your regimen. Aim for 150 minutes or more each week. Find out your age-appropriate goal heart rate and keep an eye on it while exercising. Before beginning any fitness programme, be sure to discuss it with your doctor.
• Consume alcohol in moderation.
• Give up using tobacco goods and smoking. Attempting it alone can be challenging. You can achieve this goal and make your heart healthier with the proper resources and support.

When to consult a doctor?

There is no set timetable to adhere to. Your symptoms, your therapy strategy, and whether you require follow-up care after a procedure are all factors. Therefore, it’s essential to consult with your provider and devise a plan together.

Conclusion

Knowing the advantages and disadvantages of various treatment choices is beneficial. Every drug or procedure carries some danger. However, Atrial fibrillation treatment is necessary to strengthen your heart and lower your risk of having a stroke. Your provider will consult with you to select the ideal course of action. You can live a long and healthy life with Atrial fibrillation if you receive treatment, are monitored, and change your lifestyle.

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