Atrial Fibrillation

Atrial fibrillation (AFib) is a type of arrhythmia that occurs when electrical signals in the heart become irregular, causing the heart’s upper chamber to beat out of rhythm. Atrial fibrillation requires medical attention because when blood clots enter the bloodstream and lodge in an artery leading to the brain, it could lead to a life-threatening stroke.

Most people with AFib lead everyday lives with treatment. Do not risk life with untreated AFib. Talk to our doctors at Piedmont Medical Center for proper diagnosis and treatment.

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AFib Symptoms

People with AFib sometimes do not experience symptoms unless they undergo a physical exam. However, sometimes others experience AFib symptoms similar to arrhythmia symptoms such as:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure*

*Chest pain or pressure is a medical emergency. You may be having a heart attack. Call 911 immediately.

AFib Causes

The irregular pumping of the heart muscle may result from other conditions such as high blood pressure and coronary heart diseases. However, other causes AFib include:

  • Changes in heart tissue
    Heart tissue changes because of aging, heart disease, infection or genetics that can affect the heart's rhythm.
  • Changes in electric signaling
    Electric signaling changes because of different heart structures and a “trigger” heartbeat can cause the heart to beat slower or faster than usual.

Along with the mentioned causes of AFib, there are risk factors that may raise the risk for AFib such as:

  • Age
  • Family history
  • Race
  • Lifestyle (alcohol and drug consumption, lack of physical activity, smoking and mental health)
  • Prior surgery
  • Other medical conditions
    • Chronic kidney disease
    • Conduction disorders
    • Congenital heart defects
    • Coronary heart disease
    • Diabetes
    • Heart attack
    • Heart failure
    • Heart inflammation
    • Heart tissue that is too thick or stiff
    • Heart valve diseases
    • High blood pressure
    • Hyperthyroidism, an overactive thyroid gland
    • Lung diseases, including COPD
    • Obesity
    • Sarcoidosis

AFib Treatments

In some cases, AFib resolves on its own. Other times, it is necessary to treat an underlying condition such as an overactive thyroid, hypertension, diabetes, chronic lung disease or heart valve disease.

AFib medications, such as beta-blockers, blood thinners, calcium channel blockers, digitalis or digoxin and other heart rhythm medicines, may be prescribed to prevent blood clots or control heart rate.

Doctors may recommend other AFib treatment procedures or surgery, such as:

  • Cardioversion to shock the heart back to a normal rhythm by delivering a jolt of electricity to the heart.
  • A pacemaker to reduce AFib when a slow heartbeat triggers it. However, if this is the treatment option, the patient would also need to take blood-thinning medicines.
  • Plugging, closing or cutting off the left atrial appendage to prevent blood clotting and cause a stroke if the patient is not allowed to take blood thinners.

However, if these AFib treatments are unsuccessful, doctors could recommend atrial fibrillation ablation.

How Does Atrial Fibrillation Ablation Work?

Atrial fibrillation ablation involves threading a long, thin, flexible tube called a catheter into the heart through a blood vessel in the arm, upper thigh or neck. Live X-ray images guide the catheter into the heart. Several flexible tubes with electrodes on the tips are run through the catheter and placed in different small blood vessels in the heart.

The procedure makes it possible to locate abnormal tissue and destroy the tissue that is causing an irregular heartbeat. Two types of energy used to target the tissue are:

  • Radio frequency — generates heat
  • Liquid nitrogen — freezes the targeted area of the heart

The resulting scar line acts as a barrier between the affected tissue and the rest of the healthy heart, stopping abnormal electrical signals that cause an irregular heartbeat.

Patients may not eat or drink anything after midnight the night before the procedure. Although sedated during the procedure, a patient could still feel some lightheadedness, rapid heartbeat, burning when any medications are injected or chest discomfort when energy is applied.

An atrial fibrillation ablation procedure can last anywhere from four to nine hours. After the procedure, pressure is applied to the site where the catheter was inserted, and patients must lie still for four to six hours. Their heart rate is closely monitored during this time.

A chest X-ray, electrocardiogram or transesophageal echocardiogram may be ordered to check the heart and prevent complications. Some patients go home the same day, while others need to stay in the hospital overnight. Most people resume normal activities within a few days.

Atrial fibrillation ablation may be a more effective treatment than other medications for AFib. However, there are risks associated with atrial fibrillation ablation as with any procedure. For more information about atrial fibrillation and different treatment options, talk with your doctor.

Remember that our cardiovascular doctors at Piedmont Medical Center will consider nonsurgical options first before suggesting surgery. Treatment may vary according to your current condition and your risk factors. Consult your heart doctor for proper diagnosis and treatment.

When to Go to a Doctor

Having AFib increases the risk of having a stroke. Hence, here are warning signs:

  • Chest discomfort
  • Discomfort in the upper body
  • Shortness of breath
  • Other AFib symptoms mentioned above

In case of an emergency, remember FAST, the signs of a stroke:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911

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