Atrial Fibrillation

Atrial fibrillation is the most common irregular heart rhythm abnormality. It is caused by abnormal electrical signals that are causing the heart to beat irregularly and usually very fast.

Symptoms of atrial fibrillation are palpitations (racing heart, skipped beats, and irregular heartbeats), chest tightness, difficulty breathing, and dizziness.

This irregular heart rhythm can be constant, or it comes and goes. Sometimes it can be provoked by modifiable reasons like alcohol, caffeine or even an overactive thyroid gland.

Atrial Fibrillation is classified according to how often the episodes occur and how quickly they terminate.

• Paroxysmal (Intermittent): Irregular heart rhythm episodes that reoccur two or more times and stops on its own within seven days. The heartbeat often normalizes within a few seconds or after a few hours.
• Persistent: Irregular heart rhythm episodes that last more than seven days, or last less than seven days, but necessitates medical therapy or a procedure to restore a normal heart rhythm (cardioversion). Cardioversion is most often done by sending electric shocks to the heart through electrodes placed on the chest.
• Longstanding Persistent: Irregular heart rhythm episodes that continue for more than a year. The heart is in a constant state of fibrillation and the condition is considered permanent. In most cases, cardioversion is either ineffective or cannot be attempted.

When the heart rate stays fast and irregular for a prolonged time it requires treatment in order to avoid complications, such as stroke or developing a weak heart.

The two main problems with atrial fibrillation is the risk of developing a blood clot and the risk of a fast heart rate that may weaken the heart

• Blood clots can develop in the upper chambers of the heart because it is beating out of synchronization. The clot can travel outside of the heart along the blood vessels to the brain and cause a stroke. To decrease this risk, patients need to take anticoagulants (blood thinners).
• A fast heart rate can be very uncomfortable for some patients, leading to the symptoms of palpitations. The heart is not pumping the blood effectively in this state. If a fast heart rate is present for a long period of time, it can cause the heart to become weak. To keep the heart rate in the normal range, patients are prescribed medications to slow it down.

When a decision is made to restore regular heart rhythm, several options are available. There are medications that are called antiarrhythmic medications and are directed to convert the heart rhythm to a normal rhythm. Another treatment option is called Cardioversion and involves applying an electrical shock to the heart.

A unique treatment is called ablation. It is a procedural option that is based on the knowledge that areas of the heart are sending an excessive number of signals and causing the upper chambers of the heart to beat irregularly. This procedure involves applying heat or cold (radiofrequency or cryoablation) in order to destroy small areas that are causing abnormal heart beat.