Heart health: The common condition of atrial fibrillation

  • By Shelly Webb
  • June 1, 2010
  • 469
                        
The heart is an amazing muscle that works like a pump. Timing is the key that allows the pump to work efficiently. When timing is off the entire cardiac system can encounter problems. One very common problem connected to timing is a condition known as atrial fibrillation (AFib). AFib in simple terms is an irregular heart rhythm that starts in the atria (upper chambers) when the heart’s electrical system begins to rapidly fire many different impulses at one time. This causes a very fast, chaotic rhythm in the atria of the heart making it impossible to contract or squeeze blood effectively into the heart’s ventricle. According to cardiologist Dr. Kenneth Shafer M.D., F.A.C.C. of the Cleveland Clinic, Wooster Family Health Center, there is no one cause of AFib. Rather, it is associated with many conditions, including high blood pressure, heart valve disease, coronary artery disease and other cardiac problems. “Although there are many causes of AFib, in at least 10 percent of all cases no underlying heart disease is found,” Shafer explained. “In some cases, AFib may be related to alcohol or excessive caffeine use, stress, certain drugs, electrolyte or metabolic imbalances, severe infections, or genetic factors. The risk of AFib does increase with age, particularly after age 60.” Symptoms of AFib include heart palpitations (sudden pounding, fluttering or racing sensation in the chest), lack of energy, dizziness, chest discomfort and shortness of breath. However, it is possible to have AFib without showing any symptoms. “Some people live for years with this condition and have no problems,” Shafer said. “Many people are unaware that their heart is out of rhythm. However, AFib causes the atria to beat rapidly and irregularly and the blood doesn’t flow through as quickly. This makes the blood more likely to clot. If a clot is pumped out of the heart, it can travel to the brain, resulting in a stroke. People with AFib are five to seven times more likely to have a stroke than the general population. Clots can also travel to other parts of the body (kidneys, heart, intestines), and cause other damage.” AFib can also decrease the heart’s pumping ability and this irregularity can make the heart work less efficiently. AFib that persists over a long period of time can significantly weaken the heart and lead to heart failure. It’s a dangerous but common condition that needs more awareness. If an individual has symptoms they should definitely speak with their physician. Diagnosing AFib is normally done through various tests such as an electrocardiogram (ECG or EKG), Holter monitor, portable event monitor or a transtelephonic monitor. Each of these tests gives the cardiologist a look at current heart rhythm and other valuable information that assist him or her with diagnosis. “The goal of treatment for AFib once it’s been properly diagnosed is to restore the normal heart rhythm, control the heart rate, prevent blood clots and reduce the risk of stroke,” Shafer said. “There are many treatment options to accomplish this goal including medications, catheter-based procedures, surgery, and lifestyle changes. The type of treatment recommended for each individual will be based on their own heart rhythm and symptoms.” Medications used in the beginning of treatment may include rhythm control drugs known as antiarrhythmics. These medications help return the heart to its normal sinus rhythm or maintain normal sinus rhythm. There are also rate control medications that may be used - these medications do not control the heart rhythm but will prevent the ventricles from beating too rapidly. Other medications that may be used in treatment include anticoagulant drugs like Coumadin or aspirin which reduce the risk of blood clots and stroke. If medications fail to work correctly to control AFib, or when medications are not tolerated, other procedures may be necessary to treat the abnormal heart rhythm. In addition to these treatments, lifestyle changes may also be helpful to prevent AFib. “Limiting alcohol intake, quitting smoking, limiting caffeine and paying attention to stimulants used in cough and cold medications are good guidelines to follow if an individual is dealing with AFib,” Shafer suggested. “Staying aware of your health and knowing when symptoms are present is important. It’s also important to have regular health checkups and monitor any changes in blood pressure and cholesterol levels. These are all good practices to decrease the risk of developing heart problems.”


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