What is atrial fibrillation?
Atrial fibrillation, commonly referred to as AF or Afib, is the most common type of cardiac arrhythmia. The American Heart Association estimates that over 2.7 – 6.1 million Americans are living with AF. During atrial fibrillation:
- A rapid, disorganized rhythm starts in the upper chambers (atria) of the heart, causing the lower chambers (ventricles) to beat irregularly.
- Because of the rapid, irregular electrical signals, the atria “quiver” instead of contract normally.
- As a result, the atria do not squeeze blood effectively into the ventricles, causing the ventricles to beat irregularly, sometimes fast and sometimes slow.
What are the symptoms of atrial fibrillation?
Symptoms of atrial fibrillation can resemble those of other heart disorders. Patients in AF may have any or all of the following symptoms, however some patients with AF have no symptoms. Symptoms include:
- Irregular or fast heartbeat
- Shortness of breath
- Inability to exercise
- Chest discomfort or anxiety
Types of atrial fibrillation
Atrial fibrillation is classified according to how frequently the episodes occur and how quickly they stop. Some patients may stay in Afib while others go in and out of Afib many times throughout the day.
- Paroxysmal Afib:
This refers to Afib that occurs suddenly and then returns to a normal rhythm without treatment. The Afib may last for seconds, minutes, hours, or up to seven days before the heart returns to its normal rhythm. As the heart goes in and out of Afib, the pulse rate may change from slow to fast and back again in short periods of time.
- Persistent Afib:
Persistent Afib occurs when the Afib does not stop by itself. Medicines and/or cardioversion (an externally delivered electrical shock, administered by a healthcare provider) may be used to help the heart return to its normal rhythm. If no treatment is given, the heart will stay out of rhythm.
- Long Standing (formerly known as Permanent) Afib:
This refers to Afib that cannot be corrected. Medicines or cardioversion cannot help the heart return to a normal rhythm. The heart is always in Afib and the condition is considered permanent.
Why does it matter?
Atrial fibrillation is treatable and generally not life threatening, however, according to the American Heart Association, the most serious risk of AF is that it can lead to other medical problems including:
- STROKE – THE GREATEST RISK OF HAVING ATRIAL FIBRILLATION
Patients in AF are FIVE TIMES as likely to suffer a stroke as someone not in AF.
- Congestive heart failure from the heart having to work too hard, with particular risk if the patient also has other heart problems
- Chronic fatigue
- Additional heart rhythm problems, resulting in discomfort and anxiety
- Inconsistent blood supply, from inefficient blood circulation
What are the risk factors for atrial fibrillation?
Atrial fibrillation is most common in people 60 years of age or older. However, atrial fibrillation can occur at any age. Sometimes, atrial fibrillation has no identifiable cause, but your risk increases if you have:
- Coronary artery disease
- High blood pressure
- Heart failure
- Heart valve disease
- Lung disease
- An overactive thyroid
- Sleep apnea
- Heavy alcohol intake
- Use of medications or substances that stimulate the heart
What are the goals for treatment?
- Relieve AF symptoms and improve the patient’s quality of life
- Prevent blood clots, to decrease the risk of stroke
- Control the heart rate
- Restore and maintain sinus rhythm
Treatment for atrial fibrillation depends on how severe the symptoms are and if there are any other medical diagnoses such as heart disease or stroke. Follow this link to the American Heart Association simplified treatment guidelines.
The Saint Thomas Heart Approach
For more than two decades, Saint Thomas Heart has remained at the forefront of atrial fibrillation treatment. The team includes electrophysiologists, cardiac surgeons, nurse practitioners, registered nurses, medical assistants, and research coordinators. Our physicians are recognized experts who teach and proctor other practitioners in the field of atrial fibrillation ablation. We have been performing atrial fibrillation ablation since 1999 and have performed more than a thousand procedures, including the first cryoablation procedure and the first Left Atrial Appendage Closure procedure in the state of Tennessee. Our specialists offer treatment from medical management to advanced intervention via catheter or surgical ablation and left atrial appendage occlusion. We offer advanced technology, comprehensive, individualized care, and experienced physicians.
Our physicians use the most up-to-date technology, therapies, and medications and work as a team to develop an individualized treatment plan. After completion of your atrial fibrillation treatment plan we will ensure a smooth transition of your care back to your primary care physician. If you have other medical problems besides AF, we'll work with your other doctors to make sure that you receive coordinated care.
For more information and to schedule an appointment with a Saint Thomas Heart electrophysiologist, please call 800.345.5016.
Treatment options include:
- Blood thinning medication – anticoagulants
- Medications to control the heart rate or rhythm or both
- Cardioversion – can be chemical or electrical. A chemical cardioversion occurs when medications alone are effective in restoring the normal rhythm. An electrical cardioversion is a procedure performed in the hospital, with the patient under sedation, in which an electrical shock is used to convert an abnormal rhythm back to a normal rhythm.
- Electrophysiological (EP) Study and Catheter ablation
- Surgical Ablation
- Left Atrial Appendage Occlusion (LAAO) or Left Atrial Appendage Closure (LAAC)