Atrial fibrillation, also referred to as Afib, is a form of arrhythmia that can disrupt blood flow throughout the body. The heart pumps blood to the entire body with each heartbeat, propelling the blood through two upper chambers and then two lower chambers. In atrial fibrillation, the upper chambers of the heart beat irregularly, causing improper blood flow to the lower chambers.
Afib can increase the chances of stroke, heart-related complications, and heart failure. Atrial fibrillation episodes may be intermittent or continuous. While medications may be effective in treating the condition, surgical procedures may be necessary in some cases.
Atrial fibrillation can be classified into four main types. Paroxysmal atrial fibrillation is characterized by the sudden onset of irregular heartbeats that typically resolve within a week. The duration of the episode can vary from a few seconds to several hours. Persistent atrial fibrillation is when the irregular heart rhythm lasts for more than seven days and may require medication to regulate the heartbeat. In the case of long-term persistent atrial fibrillation, the abnormal heart rhythm lasts for over a year and does not resolve on its own. Treatment options such as medications and other therapies may be recommended by a doctor. Permanent atrial fibrillation is a type of AFib that cannot be corrected with treatment. Patients with this type of AFib typically receive long-term medications to control their heartbeat.
Atrial fibrillation may present with various common symptoms, such as an irregular heartbeat, heart palpitations, chest pain, shortness of breath, fatigue, dizziness, intolerance to exercise, lightheadedness, and weakness.
Atrial fibrillation can be caused by various conditions, such as high blood pressure, lung disease, heart valve disease, congenital heart defect, enlarged heart, heart surgery, thyroid issues, heart attack, sleep apnea, sick sinus syndrome, hypertrophic cardiomyopathy, heart failure, certain medications, smoking, and viral infections.
Atrial fibrillation may not always show noticeable symptoms. The condition can be detected by a doctor during a routine physical examination or while checking for other medical issues. If atrial fibrillation is suspected, the doctor may recommend several tests to confirm the diagnosis. These tests may include an electrocardiogram (ECG or EKG) which measures the heart's electrical signals and is considered the primary diagnostic test for atrial fibrillation. Additionally, a stress test can be conducted to observe heartbeats and other vital signs while the patient exercises on a treadmill or cycle. Other tests may include a chest X-ray to capture images of the heart and lungs, an echocardiogram to create images of the heart's structure and motion using sound waves, blood tests to check for underlying conditions like thyroid disease, and a Holter monitor, which is a portable ECG device that records the heart's activity for 24 hours or more while being worn on a belt or shoulder strap.
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Treatment options for atrial fibrillation depend on the type of condition and the underlying cause. The doctor may recommend medications as a first-line treatment to control the heart rate or restore normal rhythm. The following drugs may be prescribed:
Antiarrhythmic drugs: These medications, such as procainamide, disopyramide, propafenone, and sotalol, can help regulate the heart rhythm and prevent atrial fibrillation episodes.
Rate control drugs: These drugs, such as digoxin, beta-blockers, and calcium channel blockers, can help slow down the heart rate and prevent the ventricles from beating too fast.
Blood thinners: These drugs, such as warfarin, apixaban, dabigatran, and edoxaban, can reduce the risk of blood clots and stroke in patients with atrial fibrillation.
Electrical Cardioversion: To reset the heart rhythm, electrical shocks are delivered to the heart through electrodes placed on the chest. This procedure is known as electrical cardioversion.
Maze Procedure: The surgeon creates a pattern of scar tissues in the upper chambers of the heart using heat or cold energy during the maze procedure. Scar tissues do not transmit electrical signals, which helps to reduce irregular heartbeats.
Atrioventricular (AV) Node Ablation: Radio waves are used to destroy the atrioventricular nodes, which connect the atria and ventricles, during the AV node ablation procedure. Following this procedure, a pacemaker is required for the rest of the patient's life.
Some atrial fibrillation risk factors include: old age, male, family history, congenital heart defects, alcohol, obesity, thyroid, high blood pressure, heart disease, pericarditis, previous heart surgery, metabolic syndrome, diabetes, sleep apnea, and high-dose steroid therapy.
The following measures may help manage the symptoms of atrial fibrillation:
Maintain a healthy diet to control the risk of atrial fibrillation.
Avoid substances that can harm the heart, such as smoking, alcohol, and illicit drugs
Manage stress levels since it can raise blood pressure and heart rate, increasing the risk of atrial fibrillation.