Atrial fibrillation – what you need to know

Causes, symptoms and treatments of afib vary

red-heart-stethoscopeAtrial fibrillation (a-tree-uhl fih-bruh-lay-shun), or “afib” (ay-fib), is an irregular heart rhythm (arrhythmia) that starts in the upper parts (atria) of the heart. A common type of arrhythmia in those over the age of 60, “atrial fibrillation is being diagnosed with increasing prevalence,” says Michele Derheim, director of clinical operations at the University of Michigan Frankel Cardiovascular Center and a registered nurse. “The quicker you’re treated for an afib condition, the better your chances are for good cardiovascular health.”

Afib, which affects more than 2.5 million Americans, happens when the heart beats abnormally, causing the muscle and tissue to begin to change, or “remodel,” says Derheim.

The condition can be a gradual one that begins to exhibit symptoms as people age. Other causes of afib, according to Dr. Hakan Oral, director of University of Michigan Cardiac Electrophysiology Service, include, “heart disease, valve-related disease, coronary artery disease, hypertension, overactive thyroid and excessive alcohol intake.” There can also be a genetic component, he says.

Symptoms of afib are varied

Symptoms of atrial fibrillation are varied, says Oral. “Some symptoms of afib come and go, while others are persistent,” he says. And some people don’t experience any symptoms, making the condition difficult to diagnose. Approximately one-third of those who have afib may not be aware of it, says Oral.

Afib symptoms may include:

  • Fluttering, racing or pounding of the heart
  • Feeling dizzy or lightheaded
  • Feeling out of breath
  • Feeling weak and tired
  • Chest pain (angina)
  • Fainting

The link between atrial fibrillation and stroke

Atrial fibrillation is dangerous because it greatly increases the risk of stroke. In fact, says Oral, atrial fibrillation is the leading cause of stroke if not treated in time.

If the heart doesn’t beat strongly, blood can collect, or pool, in the atria (upper chambers of the heart). Pooled blood is more likely to form clots. If the heart pumps a clot into the bloodstream, the clot can travel to the brain and block blood flow, causing a stroke. Most people who have atrial fibrillation need to take a blood-thinning medicine to help prevent stroke, although the dangers of an anti-coagulant must be weighed against the risk of stroke. “First and foremost, an assessment must be made to decide on the risk of stroke,” says Oral.

Atrial fibrillation can also lead to heart failure.

Atrial fibrillation treatments

A number of treatments may be used for atrial fibrillation, depending on an individual’s symptoms and risk of stroke. A procedure known as electrical cardioversion can be used in patients with atrial fibrillation. Although it is very effective in restoring the normal rhythm, atrial fibrillation often recurs after the cardioversion unless other measures are taken. Usually drugs named antiarrhythmic drugs are tried first. However in patients in whom drugs have not been effective, well tolerated or not preferred, catheter ablation offers an effective treatment option says Oral.

More information about atrial fibrillation treatments

Download PDF: The Treatment of Atrial Fibrillation (The University of Michigan Electrophysiology Service)

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