Atrial Fibrillation

Atrial fibrillation (AF) is a heart condition that is characterized by a rapid, irregular heartbeat. It occurs when the heart’s electrical signals malfunction and cause the top chambers of the heart, the left and right atria, to beat out of rhythm with the lower chambers. This chaotic heart beat disrupts proper blood flow through the heart and to the rest of the body and can lead to further complications if left untreated¹.

Most individuals with atrial fibrillation will first experience heart palpitations and often report their heart “fluttering” or racing uncomfortably. The most typical, main symptoms of AF include heart palpitations, shortness of breath and fatigue². Other, less common symptoms include chest pain, dizziness, confusion, lightheadedness and reduced ability to exercise. Some people can also be asymptomatic and are not aware they have this condition¹.

There are four common types of atrial fibrillation: Paroxysmal, persistent, long standing and permanent. Paroxysmal AF is when the heart palpitations happen suddenly and not often. The episodes last only a few minutes to one hour, and the heart rhythm is restored on its’ own. Persistent AF is when the heart rhythm is not restored and lasts longer than a week. Long standing AF is when the irregular heartbeat lasts longer than 12 months. In cases of persistent and long-standing AF, treatment is needed to restore the heart rhythm^2,3. The last type, permanent AF, is the most severe type. This is when the heart rhythm cannot be restored and some medications fail to work^1,2. In some cases, the condition is inherited, and this is termed familial atrial fibrillation³.

To diagnose an individual with atrial fibrillation an electrocardiogram is conducted to detect the irregular heartbeat². The electrocardiogram will show no P waves and a high frequency of atrial waves with low amplitude⁴. Additionally, a heart rate monitor can be worn that tracks the patient’s heart rhythm and records the data.

To treat a patient with AF, there are different approaches. First, if it is a life-threatening situation, electrical cardioversion is needed. Second, catheter ablation can be performed through direct-current electrical cardioversion⁴. This is aimed to fix the atrioventricular node in the heart that is misfiring electrical signals. Pharmological cardioversion is another option to help restore the sinus rhythm⁴. Some of these medications include beta-blockers, calcium channel blockers, procainamide, amiodarone, ilbutilide, quinidine, flecainide, propafenone, disopyramide, sotalol, and dofetilide⁴. Lastly, a pacemaker can also be implanted to restore the sinus rhythm.

References:

1. Pietrangelo, Ann. “Interpreting AFib by the Numbers.” Edited by Kenneth R Hirsch, Healthline, Healthline Media, 24 Dec. 2014, www.healthline.com/health/living-with-atrial-fibrillation/facts-statistics-infographic.
2. Staff, Mayo Clinic. “Atrial Fibrillation.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Dec. 2017, www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624.
3. “What Are the Symptoms of Atrial Fibrillation (AFib or AF)?” American Heart Association, American Heart Association, Inc., 6 Feb. 2017, www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-are-the-Symptoms-of-Atrial-Fibrillation-AFib-or-AF_UCM_423777_Article.jsp#.Wm5UiLaZOL9.
4. Cantillon, Daniel J. “Atrial Fibrillation.” Cleveland Clinic , The Cleveland Clinic Foundation, Jan. 2014, www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/atrial-fibrillation/.