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Home :: Cardiology Disorders

Atrial Fibrillation

 

Acute Myocardial Infarction
Aortic Stenosis
Atrial Fibrillation
Atrial Flutter
Cardiac Arrest
Heart Block
Heart Failure
Hypertension
Hypotension
Infective Endocarditis
Ischamic Heart Disease
Mitral Stenosis
Paroxysmal Atrial Tachycardia
Rhematic Fever
Tachycardia
Wolf Parkinson White Syndrome

The heart contracts (beats) and pumps blood with a regular rhythm, for example, at a rate of 60 beats per minute there is a beat every second. During atrial fibrillation, the heart's two small upper chambers (the atria) quiver instead of beating effectively. More than 2 million Americans have this condition, which can cause palpitations, shortness of breath, fatigue and stroke. This regular rhythm occurs as a result of regular electrical discharges (currents) that travel through the heart and cause the muscle of the heart to contract. This risk exists as the lack of coordinated atrial contraction leads to unusual fluid flow states through the atrium that are permissive for formation of thrombus that is then at risk to embolize. This risk is theoretically particularly present upon return to normal sinus rhythm when coordinated atrial contraction can entrain a thrombus into flow. Atrial fibrillation occurs in episodes, but the arrhythmia does not convert back to sinus rhythm spontaneously. Medical treatment is required to end the episode. Atrial fibrillation is often caused by changes in your heart that occur with age or as a result of heart disease or high blood pressure. Atrial fibrillation may be a sporadic condition, or it may be chronic. AF is common; half a million new cases are diagnosed yearly in the U.S., and billions of dollars are spent annually on its diagnosis and treatment. We are able to do this because it has been sponsored by Astrazeneca with an unrestricted educational grant.

Atrial fibrillation is a rapid and highly irregular heart arrhythmia, caused by chaotic electrical impulses in the atria of the heart. In AF, the electrical discharges are irregular and rapid and, as a result, the heart beats irregularly and, usually, rapidly. The rate at which the atrial electrical impulses are transmitted to the ventricle is determined by a number of factors including relative refractory period within the atrioventricular (AV) node, hydration status, and presence or absence of pharmacologic agents used to control the rate. When ventricular rate increases to tachycardic levels, a situation of atrial fibrillation with rapid ventricular response (AF with RVR) ensues. The heart develops atrial fibrillation and typically converts back again spontaneously to normal (sinus) rhythm. The episodes may last anywhere from seconds to days. The Bandolier atrial fibrillation site will contain stories from Bandolier, plus abstracts of systematic reviews, meta-analyses, or other studies about AF. And they don't beat in coordination with the two lower chambers of the heart. The result is an irregular and often rapid heart rate. As a result, the heart rate becomes fast and irregular, and the normal coordination between the atria and the ventricles is lost.Although atrial fibrillation usually isn't life-threatening, it can lead to complications. Treatments for atrial fibrillation vary from person to person. But they may include medications and other interventions to try to alter the heart's electrical system.

Causes of Atrial Fibrillation

The common Causes of Atrial Fibrillation :

  • A heart attack (myocardial infarction, or MI); episodes of atrial fibrillation associated with a heart attack are usually brief, although it may become persistent.
  • Long-standing hypertension
  • After heart surgery and, less often, after other types of surgery; atrial fibrillation in these settings is typically temporary.
  • Heart failure of almost any cause.
  • Sympathomimetic drugs, alcohol, electrocution
  • Infiltrative heart disease of any type
  • High blood pressure (hypertension)
  • Pulmonary embolism (a blood clot in the lungs)
  • Enlargement of the left ventricle walls (left ventricular hypertrophy)
  • Sick sinus syndrome (improper production of electrical impulses because of malfunction of the SA node)

Symptoms of Atrial Fibrillation

Some are common Symptoms of Atrial Fibrillation :

  • Sensation of feeling heart beat ( palpitations )
  • Pulse may feel rapid, racing, pounding, fluttering, or it can feel too slow
  • Other symptoms include weakness, lack of energy or shortness of breath with effort, and chest pain .
  • Difficulty breathing
  • Pulse may feel regular or irregular
  • A sense of the heart racing
  • Dizziness
  • Shortness of breath
  • Fainting
  • Some become light-headed or faint.
  • Lightheadedness
  • Unpleasant palpitations or irregularity of the heart beat

Treatment of Atrial Fibrillation

Here is the list of the methods for treating Atrial Fibrillation :

  • Electrical cardioversion may be used to restore normal heart rhythm with an electric shock, when medication doesn't improve symptoms.
  • Surgery can be used to disrupt electrical pathways that generate AF.
  • These drugs are given under medical supervision, and are delivered through an IV tube into a vein, usually in the patient's arm.
  • Some patients with atrial fibrillation and rapid heart rates may need the radiofrequency ablation done not on the atria, but directly on the AV junction (i.e., the area that normally filters the impulses coming from the atria before they proceed to the ventricles).
  • Symptomatic patients may benefit from intravenous (IV) rate-controlling agents, either calcium-channel blockers or beta-adrenergic blockers.
  • A patient with hemodynamic instability, mental status changes, preexcitation, or angina will require urgent synchronized DC cardioversion.
  • This is usually done with medication, for example, digoxin.
  • The risk factors for pharmacologic cardioversion include bradyarrhythmia, QT prolongation, and ventricular arrhythmias.