A dancing heart: Understanding AFibLaura Rohrs, NP
What is atrial fibrillation?
Atrial fibrillation, or “a-fib” is an irregular heart rhythm caused by an abnormal electrical signal in the top part of the heart. Atrial fibrillation may come and go, (paroxysmal) or be constant (persistent). Atrial fibrillation is a problem that affects 5.3 million Americans and our risk for developing a-fib increases as we age.
When the heart is in atrial fibrillation, the top chambers of the heart (the atria) do not pump in sync with the bottom chambers (the ventricles), and instead quiver and do not contract completely. This irregular heart rhythm is not usually life threatening, as the ventricles are still pumping blood throughout the body, although in some cases, the a-fib causes the heart to beat very rapidly. The biggest danger of a-fib is due to blood not pumping through the atria in a normal fashion. This can cause a blood clot to form, which, if it travels to the brain, can cause a stroke.
Many people who have a-fib currently, or have a history of a-fib, are on an anticoagulant, or “blood thinner”. This prevents clot formation in the atria, thus reducing the risk of stroke.
Symptoms of atrial fibrillation include:
- A rapid, irregular heart rate which people may or may not notice. This is often described as a “fluttering” or “pounding” in the chest.
- Feeling lightheaded or dizzy
- Feeling short of breath
If left untreated, atrial fibrillation can cause heart failure, as well as stroke. The causes of a-fib are not always known, but can include previous heart damage (such as from a heart attack), high blood pressure, thyroid problems, problems with the heart valves, severe illness, excessive alcohol consumption, and untreated sleep apnea.
Where to Go:
If someone is experiencing symptoms of a a-fib such as a very rapid heart rate, lightheadedness, dizziness, shortness of breath, or chest pain, they should call 911 or go to the closest Emergency Room for evaluation and treatment.
If the a-fib is not symptomatic or is found by chance at a routine doctor’s appointment, a person may be referred to a Cardiology service for further evaluation and treatment. At the initial appointment, patients are evaluated to determine their risk of stroke and may be put on an anticoagulant. If their heart rate is high, medication may also be prescribed, to slow the heart down. Testing is ordered, including a wearable monitor to assess the heart rhythm and heart rate, as well as an echocardiogram (ultrasound of the heart), to examine the heart structure and function. If there are any symptoms decreased blood flow to the heart from coronary artery disease (also known an ischemia), patients may undergo a stress test as well. All of which can be done here at Health Pointe.
There are a variety of treatment options for atrial fibrillation depending on several factors, including how long it has been present, whether it is paroxysmal or persistent, and whether the patient is very symptomatic.
- Medications can be used to try and control a person’s heart rate in a-fib or to try and change their rhythm back to a normal one.
- A procedure called a cardioversion may be performed if someone is in persistent a-fib. This involves using a defibrillator to deliver a shock to the heart and allow it to “reset” back to a normal rhythm. This is performed under sedation.
- Another option for some patients is called an ablation. This procedure is done by a cardiologist who specializes in electrophysiology and is done at the Meijer Heart Center. Patients are given sedation, and a catheter is inserted into one of their veins and threaded up into their heart. The cardiologist then determines the location of the abnormal electrical signal, and terminates it, using a laser or scarring technique. This does not damage the heart muscle in any way and patients are typically sent home the same day.