Atrial Fibrillation

More than two million people in the United States suffer from atrial fibrillation (also known as AFib or AF), reports the American Heart Association. There are more than 300,000 new cases of atrial fibrillation diagnosed each year. Atrial fibrillation is the most common type of irregular heartbeat, affecting both men and women and showing an increasing prevalence with age. Between 3 to 5 percent of people over the age of 65 suffer from atrial fibrillation.

Atrial fibrillation is a heart rhythm disorder that involves a rapid heart rate in which the upper heart chambers  contract in a disorganized and abnormal manner, disrupting the heart’s ability to pump blood. The condition can be caused by impulses transmitted to the ventricles in an irregular fashion, or by impulses failing to be transmitted at all. This makes the ventricles beat irregularly, which leads to an irregular pulse in atrial fibrillation.

Atrial fibrillation increases the risk of stroke fivefold, and is a major contributor to the development of congestive heart failure as well as more serious, life-threatening arrhythmias. However, atrial fibrillation is controllable with proper treatment.

There are four main types of AF:

• Paroxysmal – AF episodes lasting less than 7 days that stop on their own without medical treatment.
• Persistent – AF episodes lasting more than 7 days or that stop only after medical treatment.
• Longstanding Persistent – Continuous AF lasting longer than 1 year.
• Permanent – AF patients who have decided not to try to have sinus rhythm restored.

Underlying risk factors and causes of atrial fibrillation or arrhythmias include dysfunction of the sinus node but also may be caused by the following:

• Heart and lung disorders including coronary artery disease, rheumatic heart disease, mitral valve disorders and pericarditis.
• Hyperthyroidism
• Hypertension
• Recent heavy alcohol use (binge drinking)
• Heart attack or soon after surgery on the heart
• Age
• Obesity
• Excessive caffeine

• Sensation of feeling heart beat (heart palpitations)
• Pulse may feel rapid, racing, pounding, fluttering or it can feel too slow
• Pulse may feel regular or irregular
• Dizziness, light-headedness
• Fainting
• Confusion
• Fatigue
• Shortness of breath
• Breathing difficulty, lying down
• Sensation of tightness or pain in the chest

There are several tests that help doctors evaluate atrial fibrillation and determine which type of treatment the patient should receive.

• ECG/EKG – records the heart’s electrical impulses (heart beats) on graph paper
• Holter Monitor – device worn by patients that provides 1-2 days of continuous ECG readings
• Mobile Outpatient Monitor – device worn by patients for up to 21 days that continuously records heart rhythm
• Echocardiogram – uses ultrasound to evaluate heart size, pumping strength and how well valves function
• Stress Test – assesses effect of stress on the heart brought on by exertion

The University of Tennessee Medical Center offers the Mini-Maze Procedure, a minimally invasive surgery that brings hope to atrial fibrillation patients for whom no reasonable cure existed. Until recently, there have been few treatments for atrial fibrillation. In some cases, atrial fibrillation may need to be treated with emergency treatment to convert the arrhythmia to normal rhythm. Atrial fibrillation accounts for approximately one-third of hospital admissions due to arrhythmias.

Treatment options include:

• Surgical Therapy – Minimally Invasive Maze Procedures
• Catheter-Based Therapy
• Cardioversion – Electrical shock delivered to heart so it beats regularly again (does not cure AF)
• Medication – Anticoagulants, rhythm control drugs and rate control drugs.

Atrial Fibrillation is a serious condition. It is possible to manage and even cure AF with proper medical care. There are options available by discussing your condition with a knowledgeable healthcare professional. Follow your doctor’s recommendations for the treatment of atrial fibrillation and other underlying disorders.

Make an appointment with your doctor today or call University Cardiology at 865-544-2800.