Atrial fibrillation is commonly demonstrated by an irregular heartbeat that can lead to blood clots, stroke, heart failure, and other similar heart complications. As common as it is, the condition is not life-threatening. Remain untreated; it may result in the above-mentioned complications, therefore, it needs to be addressed with immediate medication management. Higher is the risk of people developing it post 65 but no surety as to what age can it occur.
Symptoms:
- Heart palpitations like flip-flopping of heart
- Shortness of breath
- Generalized weakness
- Reduced endurance
- Dizziness or lightheadedness
- Chest pain
Types of Atrial fibrillation:
- Occasional- The symptoms come and go, each lasting a few minutes to a few hours even a week
- Persistent- Symptoms stays and needs treatment to be normal again
- Long-Standing – Symptoms stay for more than 12 months
- Permanent- Normal heart rhythm cannot be restored and needs medication to control heart rate and blood clots
Causes:
- Defective system of heart due to chaotic electrical signals
- Increased blood pressure
- Heart attack
- Coronary artery disease
- Abnormal heart valves
- Congenital heart defects like mitral valve regurgitation
- An overactive thyroid gland or other metabolic disorders
- Exposure to stimulants like certain medications, caffeine, tobacco or alcohol
- Sick sinus syndrome — improper functioning of the heart’s natural pacemaker
- Lung diseases
- Previous heart surgery
- Viral infections
- Stress due to surgery, pneumonia or other illnesses
- Absence of proper Sleep
Risk Factors
- All of the above
- Age
- Diabetes
- Excessive alcohol Intake
- Obesity
- Family history of AF
Complications:
- Stroke- Disturbed rhythm causes blood to pool in the upper chambers of the heart rather than flowing naturally. This pooled blood may form clots that may enter the artery supplying brain causing Stroke.
- Heart failure- Blood pooling makes the heart weak, therefore it cannot force blood through the entire body, causing heart failure.
Preventive Measures:
- Eat healthy and optimum
- Avoid smoking
- Improve physical activity
- Maintain a healthy weight
- Avoid excessive caffeine
- Limit alcohol Intake
- Reduce stress
- Limit over the counter medication (sp. some cold and cough drugs)
Diagnosis:
- ECG- Electrocardiogram with leads attached to your chest
- Holter Monitor- Continuous monitoring and recording ECG through a portable pocket ECG machine.
- Event Recorder- Like holter, it records heart signals, once a person experience symptoms, he pushes a button that records it which can be used to evaluate the ECG at time of symptoms.
- Echocardiogram- A handheld device creates moving pictures of your heart using sound waves. It can be inserted into your throat for diagnosing structural heart disease and locating blood clots.
- Stress Test- TMT or treadmill test-taking ECG while running.
- Chest X-Ray- To see cardiomegaly, mainly differential diagnosis.
- Blood Test- To detect an underlying problems like hyperthyroidism.
Treatment:
- Conservative management-Depends on the underlying cause
- Electrical Cardioversion- After administering a mild sedative, an electrical shock is given through paddles or patches. The electrical activity of your heart stops and resets.
- Cardioversion with drugs- Anti-arrhythmic medication along with monitoring of heart rate. This is supplemented by blood-thinning drugs as well.
- Heart Rate control drugs like calcium channel blockers, Beta-blockers
- Blood Thinners
- Surgical Management
- Catheter ablation- Catheter is guided from leg to heart with a tip releasing radio waves or cold or heat destroying tissue causing arrhythmia
- Maze Procedure- Scalpel / Radio waves or cryotherapy to stop atrial fibrillation.
- Atrioventricular (AV) node ablation- Destruction of AV node followed by installing a pacemaker to lower chambers.
- Left atrial appendage closure- Catheter from leg to heart to prevent blood clots.
- Lifestyle changes
- Quit smoking
- Be physically active
- Lose weight
- Take your BP or other medication on time
- Limit alcohol intake
- Diet Therapy
- Lots of fruits and vegetables
- Lessor no known vegetarian diet
- Less on Vitamin K intake
Stay Aware, Healthy and happy …
Dr. Vivek Chaturvedi, Senior Consultant – Cardiology & Director – Electrophysiology – Cardiology – Adult, Cardiology – Paediatric, Electrophysiology | Narayana Superspeciality Hospital, Gurugram