Doctor's Notes on Atrial Fibrillation (AFib)
Atrial fibrillation is an irregular heart rhythm (arrhythmia) that causes the atrial chambers of the heart to beat rapidly. Signs and symptoms of atrial fibrillation (also termed A fib, AFib, A-fib) may include
- palpitations (sensation of a rapid and/or irregular heartbeat),
- dizziness or lightheadedness,
- chest pain and/or angina,
- shortness of breath, and/or
The cause of atrial fibrillation is due to multiple sources of impulses in the atria that travel through the atria at the same time and cause irregular usually rapid contractions of the atria that are not correlated with ventricular contractions although ventricular contractions are also frequently increased. Other cardiac conditions may eventually cause atrial fibrillation (for example, heart valve disease, ventricular hypertrophy, coronary heart disease, congestive heart failure, advancing age and others).
What Are the Treatments for AFib?
The treatments for AFib attempt to slow your heartbeat and/or restore a normal cardiac rhythm and prevent clots. The following represent some of the numerous drugs used:
- Blood thinners (for example, aspirin, warfarin, rivaroxaban)
- Beta-blockers (slow heart rate) (for example, atenolol, metoprolol, carvedilol)
- Calcium channel blockers (slow heart rate): diltiazem, verapamil
- Heart rhythm drugs (slow electric signals in the heart): sodium and potassium channel blockers (for example, flecainide, amiodarone)
Other procedures can be tried if drugs do not work well. They are as follows:
- Electrical cardioversion
- Catheter ablation (radiofrequency or cryoablation)
- Surgical ablation (Maze procedure or Mini Maze)
- Pacemaker (when the AV node is ablated, device generates electric pulses that make the heart beat)
Your doctor will suggest the best treatments for your AFib problem.
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Arrhythmias (Heart Rhythm Disorders)Arrhythmias or heart rhythm disorders are conditions that causes changes in the normal heartbeat. There are numerous types of arrhythmias, for example, supraventricular tachycardia, sinus sick syndrome, atrial fibrillation, atrial flutter, and ventricular fibrillation. Signs and symptoms of an arrhythmia may include: Chest pain or discomfort Shortness of breath Palpitations Racing heart sensation Treatment for arrhythmias depend upon the cause.
Atrial FlutterAtrial flutter is a type of arrhythmia, that is, an irregularity in the beating of the heart. Symptoms of atrial flutter include heart palpitations, shortness of breath, anxiety, weakness, and a fluttering feeling in the chest. Causes of atrial flutter include heart disease, hypertension, heart muscle disease, heart abnormalities, substances, and diseases that affect other areas of the body. Treatment of atrial flutter includes defibrillation and medication.
Blood ClotsBlood is supposed to clot to help repair a blood vessel that is injured. Clots or thrombi become a problem when they form inappropriately. There are a variety of illnesses and risk factors that can lead to blood clot formation such as atrial fibrillation, heart attack, strokes, transient ischemic attacks (TIAs), pulmonary embolism, deep vein thrombosis (DVT), and more. Diagnosis and treatment of blood clots depends on the cause and severity of the clot.
Congestive Heart Failure (CHF)Congestive heart failure, or CHF, is a condition in which a person's heart is failing and it can't pump enough blood and oxygen to the body's tissues. Sometimes people with CHF don't know they have it. Early signs and symptoms symptoms are cough, shortness of breath, and having problems breathing; especially when lying down. And, if you have breathing problems like asthma, COPD, or emphysema and you think your condition is worsening. There are four stages of CHF. There's no cure for CHF, but treatments include drug therapy, diet, and lifestyle changes to relive symptoms and slow the progression of the disease. Life expectancy depends on existing medical problems, age, and overall health.
Hardening of the Arteries (Atherosclerosis)Atherosclerosis is the term referring to a hardening of the arteries caused by buildup of fat and cholesterol on the artery walls. The deposits, called plaque, can eventually block blood flow. Obesity, high cholesterol, age and a number of other factors put people at risk for atherosclerosis. Treatment may include lifestyle changes, surgery, and medication.
Heart AttackA heart attack is an interruption in blood flow to the heart muscle. Arterial plaque rupture is often the cause of a heart attack. Symptoms of a heart attack may include chest pain, shortness of breath, sweating, and nausea. Emergency heart catheterization and thrombolytic therapy may be used to treat a heart attack.
Heart DiseaseCoronary heart disease (CHD) is a group of different types of heart disease. Symptoms of heart disease depend on the cause and inclue chest pain or angina, shortness of breath, palpitations, and dizziness. Many conditions causes heart disease, for example, genetics, obesity, high cholesterol, and smoking. Treatment for heart disease depend on the cause and include diet and other lifestyle changes, medications, procedures, and surgery. The prognosis (outlook) and life span for someone with heart disease varies depending on the cause.
High Blood Pressure (Hypertension)High blood pressure (hypertension) may be present in an individual, without any symptoms. Thus, it is called the "silent killer." Causes of high blood pressure include heart disease, kidney disease, tumors, birth control, alcohol, thyroid dysfunction, and birth control pills.Treatment of high blood pressure is generally through diet, exercise, and medication if necessary.
High CholesterolHigh cholesterol levels can lead to heart disease, stroke, angina, blood clot formation, stroke, and peripheral artery disease. Causes of high cholesterol include heredity, age, gender, stress, and lifestyle choices. Cholesterol levels can be reduced with lifestyle changes and medication if necessary (statins, fibrates, bile acid sequestrants, or niacin).
HyperthyroidismHyperthyroidism refers to a condition in which the thyroid gland produces too much thyroid hormone. Causes of hyperthyroidism include: Graves' disease, thyroid adenoma, thyroid goiter, subacute thyroiditis, and drug-induce hyperthyroidism. Symptoms of hyperthyroidism include irritability, heart palpitations, heat intolerance, weight loss or gain, frequent bowel movements, lower leg edema, infertility, fatigue, and more. Treatment for hyperthyroidism depends on the cause and can include medications or surgery.
Low Blood Pressure (Hypotension)Low blood pressure (hypotension) may be caused by heart conditions, intravascular fluid complications (dehydration, pneumonia, vomiting, diarrhea, bleeding), medications, endocrine conditions, allergic reactions, orthostatic hypotension, diabetes, and micturition syncope. Low blood pressure may or may not have symptoms depending upon the cause. Treatment also depends upon the causes of low blood pressure.
PalpitationsHeart palpitations are an abnormality of the normal heart beat and rhythm, and are a symptom of another disease or problem. Causes of heart palpitations include heart disease or other heart problems (mitral valve prolapse, atrial fibrillation), during pregnancy, perimenopause, menopause, postmenopause, anxiety, emotional stress, stimulants (caffeine, alcohol, drugs), and some over-the-counter and prescription medications. Other symptoms that may accompany heart palpitations include nausea, vomiting, sweating, shortness of breath, and angina (heart pain). Some types of heart palpitations can be fatal, for example, ventricular fibrillation or ventricular tachycardia.
PericarditisPericarditis is a condition in which the thin membrane that lines the heart becomes inflamed. In most cases of pericarditis, the cause is not known. The most common symptom of pericarditis is chest pain. Treatment is generally ibuprofen; however, if the condition is life-threatening surgery may be required. There is no way to prevent pericarditis.
Pulmonary EmbolismA pulmonary embolism (PE) is a blood clot in the lung. The clot typically comes from other areas of the body and travels to the lung, where it becomes lodged. Pulmonary embolism can cause serious problems, from shortness of breath to instantaneous death, depending on the nature of the clot.
StrokeStroke is a medical emergency. When a person has a stroke, part of the blood supply to the brain is cut off or greatly decreased. There are two main types of stroke, ischemic and hemorrhagic. Stroke symptoms include dizziness, sudden headache, weakness in an arm or leg on the same side, weakness in the muscles of the face, difficulty speaking, vision problems, and more. Treatment of stroke depends on the type and severity of the stroke suffered.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.