Atrial fibrillation— Causes, Symptoms, Diagnosis and Treatment

Atrial fibrillation, put simply, is an irregular heartbeat (arrhythmia) that are likely to cause  blood clots, stroke, heart failure and other heart-related complications.

Causes

Atrial fibrillation means your heart rate in atrial fibrillation may range from 100 to 175 beats a minute ( The normal range for a heart rate is 60 to 100 beats). Possible causes include:

  • High blood pressure
  • Heart attacks
  • Coronary artery disease
  • Abnormal heart valves
  • Heart defects you’re born with (congenital)
  • An overactive thyroid gland or other metabolic imbalance
  • Exposure to stimulants, such as medications, caffeine, tobacco or alcohol
  • Sick sinus syndrome — improper functioning of the heart’s natural pacemaker
  • Lung diseases
  • Previous heart surgery
  • Viral infections
  • Stress due to pneumonia, surgery or other illnesses
  • Sleep apnea

There is an exception-lone atrial fibrillation.  In this condition, your atrial fibrillation don’t have any heart defects or damage, but you just experience the atrial fibrillation. Reason here is not clear.

 

Symptoms

Some people may have no symptoms. Those who do have symptoms may experience symptoms like:

  • Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest
  • Weakness
  • Chest pain
  • Reduced ability to exercise
  • Fatigue
  • Lightheadedness
  • Dizziness
  • Confusion
  • Shortness of breath

 

Diagnosis

The diagnosis of the AFib needs your medical history, and a physical examination. Here are several tests to diagnose your condition, including:

1.Electrocardiogram (ECG).
This test senses and records your electrical signals, which is a primary tool for diagnosing atrial fibrillation.

2.Holter monitor.

This portable ECG device can record your heart’s activity for 24 hours or longer.

3.Event recorder.

This portable ECG device will record your heart activity as you feel the symptoms and push a button, working as a weekly or monthly monitor.

4. Echocardiogram.
This noninvasive test can produce a video image of your heart for detecting underlying structural heart disease.

5. Blood tests.
Blood tests can rule out thyroid problems or other substances in your blood .

6. Stress test.
This is also called exercise testing. It tests your heart condition while you’re exercising.

7. Chest X-ray.
X-ray images shows both the health condition of your lungs and heart, which can give you an overall exam except for the

 

Treatment
The specific treatment depends on your AFib history, the intensity of your symptoms and the underlying cause. Generally, the treatment goals contain three points:

  • Reset the rhythm or control the rate
  • Prevent blood clots
  • Decrease the risk of strokes

1. Resetting your heart’s rhythm

Ideally, if you can get your heart rate and rhythm back to normal, the AFib will disappear.

Step 1: reset your heart to its regular rhythm
Here your doctor may use a procedure called cardioversion, according to the underlying cause of AFib and your AFib history. Cardioversion comes in two ways:

Electrical cardioversion.
This brief procedure includes an electrical shock. The shock stops your heart’s electrical activity momentarily via paddles or patches delivering under sedation. Hopefully, the heart will work normally from next activity.

Cardioversion with drugs.

Anti-arrhythmics are also used in this form of cardioversion in the way of intravenous or oral medications, helping restore your normal sinus rhythm.

Step 2:  maintain a normal heart rhythm
After cardioversion, your doctor may prescribe anti-arrhythmic medications to help prevent future episodes of atrial fibrillation. Medications may include:
Dofetilide (Tikosyn)
Flecainide
Propafenone (Rythmol)
Amiodarone (Cordarone, Pacerone)
Sotalol (Betapace, Sorine)

These drugs may be useful, but you should be careful of its side effects, including nausea, dizziness and fatigue.

Step 3:  heart rate control
Medications prescribed to control your heart rate is also helpful to restore it to a normal rate. For most people, digoxin (Lanoxin) may help to control heart rate at rest, rather than during activity, so additional medications such as calcium channel blockers or beta blockers are necessary.
Once again, stay alert to the possible side effects. Beta blockers may cause low blood pressure.  For those with heart failure or low blood pressure, calcium channel blockers can be  marked with yellow highlight in their medication list.

 

2.Preventing blood clots

AFib is much likely to cause blood clots and stroke. So the prevention of blood clots is also an important part of the treatment. If you are looking for some medicines to take a try, the following blood-thinning medications are recommended:

Warfarin (Coumadin, Jantoven).
Warfarin is powerful at blood thinning and meanwhile it may cause dangerous bleeding. You better take some regular blood tests to monitor its effects and carefully follow your doctor’s instructions.

Newer anticoagulants
This medicine works in a shorter way than warfarin and need no monitoring. However, if you have mechanical heart valves in your body, just avoid it directly.

Dabigatran (Pradaxa)
This is effective as warfarin and need no blood tests. If you have mechanical heart valves in your body, just avoid it directly.

Rivaroxaban (Xarelto)
A once-daily medication and don’t stop taking it without doctor’s instruction.

Apixaban (Eliquis)
It’s as effective as warfarin for preventing strokes.

3. Decrease the risk of strokes

Change your lifestyle is the simplest and best way to improve the overall health of your heart, decreasing your risk of strokes. Those lifestyle changes listed maybe helpful:
Eat heart-healthy foods low in salt and solid fats, and try more fruits, vegetables and whole grains.
Exercise regularly, at least three times a week.
Quit smoking.
Maintain a healthy weight.
Keep blood pressure and cholesterol levels under control.
Drink alcohol in moderation.
Maintain follow-up care.

 

 

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.