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Atrial Fibrillation PDF Print E-mail
Tuesday, 02 April 2013 04:00

Chananya Chaiyaumporn, MD.

What is atrial fibrillation?

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia which causes a fast and erratic heartbeat. If you have AF

·         Your heart rate is usually a lot faster than normal.
·         Your heartbeat is irregular - that is, an abnormal heart rhythm (an arrhythmia).
·         The force of each heartbeat can vary in intensity.

What happens is that the normal controlling timer in the heart is overridden by many random electrical impulses that fire off from the heart muscle in the atria. The atria then fibrillate. This means that the atria only partially contract - but very rapidly. Only some of these impulses pass through to the ventricles in a haphazard way.

How common is atrial fibrillation?

AF affectes 1-2% of the population. The prevalence of AF increases with age from less than 0.5% at age 40-45 years, to 5-15% at 80 years.

What are the symptoms of AF?

Symptoms often develop quickly, soon after the AF develops. Possible symptoms include:

1. palpitation

2. breathlessness

3. angina

4. dizziness or near syncope

Many people with AF have no symptoms, particularly if their heart rate is not very fast. The AF may then be diagnosed by chance when a doctor feels your pulse.

What causes atrial fibrillation?

Causes of AF include the following:

1.       AF is a common complication of various heart conditions. For example, AF occurs in some people with ischemic heart disease, cardiomyopathy, valvular heart disease and pericardial disease.

2.       Hypertension, diabetes, hyperthyroid, obesity

3.       Respiratory disease: COPD, OSA

4.       CKD

5.       drinking a lot of alcohol, drinking a lot of caffeine

6.       post cardiac surgery

In about 1 in 10 cases of AF there is no apparent cause. The heart is otherwise fine and there are no other diseases to account for it. This is called lone AF.

What are the possible complications of atrial fibrillation?

The main complication of AF is an increased risk of having a stroke (5-fold). AF causes turbulent blood flow in the heart chambers. This sometimes leads to a small blood clot forming in a heart chamber.The risk of developing a blood clot and having a stroke varies, depending on various factors.

What are the treatment options for atrial fibrillation?

Treatments that may be considered include:

·         Rate control. This means bringing the heart rate back down to normal. This is done for all people with AF who have a fast heart rate (that is, most cases).

·         Rhythm control. This means converting the irregular rhythm back to a normal regular rhythm. This is only possible in some cases.

·         Anticoagulation treatment which aims to prevent a stroke.

·         Other treatments in certain circumstances.

 

A newer technique to restore the heart rhythm is called catheter ablation. In this procedure a catheter (a long thin wire) is passed into the chambers of the heart via a large blood vessel in a leg. The tip of the catheter can destroy tiny sections of heart tissue that may be the source or trigger of the abnormal electrical impulses. This treatment is only suitable in certain cases and is not a routine treatment. It does not always work and there is a small risk of serious complications. Your doctor will discuss with you in more detail if you are suitable to have rhythm control treatment and which method of cardioversion would be best for you.


 

 

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