Atrial fibrillation (A-Fib) is an irregular heart rate that can lead to blood clots, stroke, heart failure and other heart related complications. It is the most common cardiac arrhythmia seen by physicians, affecting men more than women.
“Normally the heart contracts and relaxes to a regular beat, between 60-100 beats per minute (BPM). With A-Fib the heart’s two upper chambers beat out of coordination with the two lower chambers, sometimes up to 300 BPM,” says McFarland Clinic Cardiologist Qiangjun Cai, MD.
A-fib can be a result of many different factors including:
- High blood pressure
- Heart vessel blockage
- Abnormal or leaking heart valves
- Overactive thyroid gland
- Alcohol, caffeine, stimulants
- Pulmonary embolism or lung disease
- Psychological stress
- Sleep apnea
- Heart failure
“Not all people with atrial fibrillation will have symptoms and symptoms can vary from person to person,” says Dr. Cai.
The most common symptoms include heart palpitations, racing or fluttering, shortness of breath, lightheadedness or dizziness, weakness and chest pain.
To diagnose atrial fibrillation, the following tests may be recommended:
- Electrocardiogram (ECG)
- Holter Monitor
- Event monitor
- Blood work
“The Holter monitor when symptoms are present every day. A patient wears a small monitor that has electrodes attached to the chest and records the electrical activity of the heart,” says Dr. Cai. “Event monitoring is used when symptoms are not present every day. Recordings are taken whenever the patient has symptoms and press the button for one month and reported back to the physician.”
Because of erratic beating blood is not effectively moved from the atria to the ventricles resulting in poor blood flow to areas of the body. Blood clots can form from the rapid beating and can break off and travel to the brain.
“Having A-fib increases the likelihood of a stroke five times. 20% of strokes are a result of A-fib, easily making it the most common complication,” says Dr. Cai. “It can also weaken the heart causing heart failure.
Treatment for atrial fibrillation correlates to three goals:
- Slow down the heart rate
- Restore and maintain normal rhythm
- Prevent stroke
"Beta blockers and calcium channel blockers are the most common medications used to slow down the heart. Our goal is for resting heart rate to be 60-80 BPM and between 90-110 with exertion,” says Dr. Cai.
Rhythm control helps to reduce the symptoms and improve the quality of life. It also improves the heart function and reduces heart failure complications.
“Rhythm control can be achieved using medications or through more invasive procedures like catheter ablation or surgical ablation. Each procedure is effective but does come with some risks,” says Dr. Cai.
Blood thinners are used to prevent coagulation that can cause blood clots.
“Warfarin is the most commonly used oral anticoagulant. It is very effective and relatively inexpensive but does require strict monitoring of blood thickness,” says Dr. Cai.
Learn more about atrial fibrillation using the following online resources: