This is the most common type of persistent arrhythmia (irregular heart rhythm) and affects many individuals here in Anguilla, especially those older than sixty years old. If not treated, it can have serious complications like leading to a stroke. Fortunately, once accurately diagnosed and treated many of these complications can be prevented.
What is atrial fibrillation?
Atrial fibrillation, also called atrial flutter by some, is an irregular heart rhythm (arrhythmia) that starts in the upper parts (atria) of the heart.
Normally, the heart beats in a strong, steady rhythm. In atrial fibrillation, a problem with the heart’s electrical system causes the atria to quiver or fibrillate. The quivering upsets the normal rhythm between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm.
The main danger of atrial fibrillation is that the heart does not pump blood well when it is beating too fast. When blood is not pumped well, vital organs, such as the heart and brain, may not get enough oxygen from the blood.
Atrial fibrillation is dangerous because it greatly increases the risk of stroke. If the heart does not beat strongly, blood can collect, or pool, in the atria. Pooled blood is more likely to form clots. If the heart pumps a clot into the bloodstream, the clot can travel to the brain and block blood flow, causing a stroke. Atrial fibrillation can also lead to heart failure.
What causes atrial fibrillation?
Conditions that damage or strain the heart commonly cause atrial fibrillation. These include:
• High blood pressure (especially if not controlled for a long time)
• Conorary heart disease.
• Heart attack.
• Heart valve disease, especially diseases of the mitral valve.
Atrial fibrillation may also be caused by:
• Other medical problems such as lung disease, pneumonia, or a high thyroid level (hyperthyroidism).
• Heart surgery.
• Heavy alcohol use. Having more than 3 drinks a day, over many years, can cause long-lasting atrial fibrillation. Drinking a large amount of alcohol at one time (binge drinking) may also cause a spell (episode) of atrial fibrillation.
• Use of stimulants. These include caffeine, nicotine, medicines such as decongestants, and illegal drugs such as cocaine.
• Use of some prescription medicines, such as albuterol or theophylline.
Sometimes despite extensive investigations no cause can be found. Doctors call this lone atrial fibrillation.
What are the symptoms?
Symptoms of atrial fibrillation may vary from one individual to another, and in some persons it may not cause obvious symptoms. When symptoms occur they include the following:
• Feeling dizzy or lightheaded.
• Feeling out of breath.
• Feeling weak and tired.
• A feeling that the heart is fluttering, racing, or pounding (palpitations).
• A feeling that the heart is beating unevenly.
• Chest pain (angina).
• Fainting.
If you have any of the above symptoms, see your doctor as soon as possible. Treating atrial fibrillation right away can help you avoid serious problems.
How is atrial fibrillation diagnosed?
During your visit to your doctor you will have a detailed history taken. Your doctor will ask questions about your past health, perform a physical exam, and will arrange a series of tests. The best way to find out if you have atrial fibrillation is to have an electrocardiogram (ECG). An ECG is a test that checks for problems with the heart’s electrical activity.
How is atrial fibrillation treated?
A number of treatments may be used for atrial fibrillation. Which treatments are best for you depend on the cause, your symptoms, and your risk of stroke.
Doctors sometimes use a procedure called cardioversion to try to get the heartbeat back to a normal rhythm. This can be done using either medicine or a low-voltage electrical shock (electrical cardioversion). You and your doctor will decide on the best treatment options. Your doctor might also put you on anti-coagulants (blood thinners) to help prevent clot formation.
What can you do to help your heart?
Atrial fibrillation is often the result of a heart condition. Making changes to improve your heart condition will usually improve your overall health. Some of these changes include:
• Not smoking. If you smoke, try to quit.
• Controlling your cholesterol. This can be done by diet and exercise, and medicines if needed.
• Controlling your blood pressure. Follow a low-sodium, low-fat, and low-saturated fat diet; increase your exercise; decrease alcohol intake; and take medicines, if needed, to control your blood pressure.
• Eating a heart-healthy diet. This includes eating a variety of fruits, vegetables, and whole grains. Limit sodium and saturated fat. Eat fish, especially oily fish like salmon and tuna, at least twice each week.
• Not using alcohol, caffeine, or stimulants, such as cocaine. Be aware that some nonprescription medicines, especially cold and herbal remedies, contain stimulants that can trigger atrial fibrillation. Talk to your doctor or pharmacist before taking any new medicine.
• Get involved in regular exercises.
Check your heartbeat regularly. To learn how to check your pulse, a health care provider can assist you with this. If you notice that your heartbeat does not have a regular rhythm, talk to your doctor. Checking your heartbeat is important because many people do not have symptoms of atrial fibrillation.
When to Seek Medical Care
If an individual experiences any of the symptoms suggestive of atrial fibrillation, a health care provider should be called for an appointment. If symptoms are severe or alarming, urgent medical attention should be sought.
If a person is taking any medication for atrial fibrillation and experiences a change or worsening of the symptoms, a health care provider should be called.
If a person has been diagnosed with atrial fibrillation and is being treated, medical attention should be sought immediately at a hospital emergency department if any of the following symptoms are experienced:
• Chest pain
• Feeling faint or light-headed
• Fainting
Conclusion
Atrial fibrillation affects individuals living in Anguilla. This heart disorder when diagnosed, and correctly treated, is seldom life-threatening. If not diagnosed, several complications, such as a stroke, can develop with serious consequences. If you have an irregular pulse or symptoms suggestive of atrial fibrillation you should see your doctor.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
