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What is atrial fibrillation and how is it treated?

Atrial fibrillation is an irregular and rapid heartbeat due to disorganized signals from the electrical system of the heart. During atrial fibrillation, upper chambers of the heart may beat as fast as 400 times a minute. This may cause devastating symptoms such as heart failure, stroke or even death.

Why is atrial fibrillation a problem?

Atrial fibrillation is increasingly common as the general population ages. The estimated lifetime risk of developing atrial fibrillation is 22 to 26 percent for individuals 40-55 years of age.

What are the symptoms of atrial fibrillation?

Atrial fibrillation causes rapid or racing heart rate, lightheadedness, fainting, fatigue, lack of energy, stroke, shortness of breath, and an inability to exercise and perform day-to-day activities or heavy work. Atrial fibrillation can occur without any of these symptoms. People without any symptoms are at risk of stroke and heart failure due to delay in seeking medical care. People with no symptoms may be diagnosed by an exam and an electrocardiogram (EKG).

What are the risk factors that cause someone to develop atrial fibrillation?

Prior heart attack, diabetes, high blood pressure, obesity and sleep apnea can increase the risk of developing atrial fibrillation. Certain habits like smoking and excessive alcohol or caffeine intake may be associated with atrial fibrillation.

What is the risk of stroke with atrial fibrillation?

During atrial fibrillation, the heart does not pump blood effectively and blood may remain stagnant in the upper chamber of the heart for a long period of time leading to the formation of clot(s). These clots can travel to brain and cause a stroke. Atrial fibrillation can increase the risk of stroke up to 5 times.

How is the risk of stroke lowered with atrial fibrillation?

Certain medications called “anticoagulation” can lower the risk of stroke with atrial fibrillation. A doctor can provide you more details about it. Staying in normal rhythm may also reduce the risk of stroke as compared to staying in atrial fibrillation.

Does atrial fibrillation run in families?

Yes, it can. Having a family member with atrial fibrillation increases the risk up to 40 percent. Genetic studies are being performed to predict the risk of atrial fibrillation.

What are the goals of treatment for atrial fibrillation?

Goals of treatment are to restore the heart to normal rhythm, to prevent stroke, to prevent heart failure related to rapid heartbeat, to improve quality of life and exercise tolerance.

Do I need to see a doctor?

A doctor can do a routine evaluation to ensure that you are not in atrial fibrillation. Starting proper treatment may reduce the likelihood of having a stroke or heart failure. You should work with your doctor to make sure every possible step is being taken to prevent any complications that could occur as a result of having atrial fibrillation. Certain cardiologists are specialists for atrial fibrillation. These include heart rhythm specialists and electrophysiologists.

What is catheter ablation?

Catheter ablation is a procedure to restore abnormal heart rhythm. A heart rhythm specialist (electrophysiologist) will insert a tube-like catheter via veins in the leg to the heart. The catheter is used to block faulty electrical impulses in the heart.

How is atrial fibrillation effectively treated?

One of the pillars of management of atrial fibrillation is to improve symptoms leading to improvement of quality of life. Multiple studies have showed that treating atrial fibrillation with maintenance of normal rhythm improves quality of life and helps people live longer. Maintaining normal rhythm also may reduce risk of stroke.

There are several medications specific for atrial fibrillation (antiarrhythmic drugs). Medications are not always effective in maintaining normal rhythm and may carry significant long-term side effects. Catheter ablation is the most common way to maintain normal rhythm in patients with atrial fibrillation.

Multiple studies performed across many centers in the world have shown that catheter ablation is the most effective way to treat atrial fibrillation and helps improve quality of life and reduce hospitalization related to atrial fibrillation. Atrial fibrillation may cause congestive heart failure and catheter ablation has shown to prevent and even improve congestive heart failure caused by atrial fibrillation.

Catheter ablation:

  • Is the most effective way to control atrial fibrillation
  • Results in symptomatic improvement
  • Results in improvement of quality of life and exercise capacity
  • Improves overall outcome and may reduce mortality
  • Reduces hospitalization