Atrial fibrillation (AF or Afib) is an irregular heart rhythm caused by an electrical misfiring of the upper chambers of the heart. In a normal heart, conduction begins when the two upper chambers called the atria, contract causing the two lower chambers called the ventricles, to fill with blood. Once filled with blood, the two ventricles contract and pump blood to the rest of the body.
When a person has Afib, the upper chambers “fibrillate” and do not contract forcefully and are not in coordination with the lower chambers. This can cause a variety of symptoms in some patients, while others experience no symptoms at all.
It is important for patients and caregivers to recognize signs of Afib. Patients may have symptoms of an irregular or racing heartbeat, dizziness, fatigue, shortness of breath, and exercise intolerance.
Symptoms can be due to the heart beating too fast, beating too slow, or an inadequate filling of blood which may result in a decreased pumping efficiency of the lower chambers of the heart. It is unclear why some patients living with Afib are very symptomatic while others may not even be aware they are in an abnormal rhythm. Some atrial fibrillation treatments are aimed at reducing these symptoms, while other strategies are aimed at restoring a normal heart rhythm. Restoring a normal heart rhythm may include anti-arrhythmic medications, electrically restarting the heart, or an ablation of the heart.
Anti-arrhythmic medications act by changing the electrical function at a cellular level. There are several anti-arrhythmic medications and it is important for the patient or caregiver to know which medications are being taken and the side effects that may be associated with that medication. It is also important that anti-arrhythmic medications are taken as prescribed and only to discontinue or restart medications under the direction of the physician.
Electrically restarting the heart or an electrical cardioversion may be recommended for patients living with Afib. If scheduled for a cardioversion, the patient or caregiver should follow the pre-procedure instructions given by the physician.
A physician may also recommend an ablation to treat Afib. An ablation is a procedure that aims at destroying a small amount of tissue inside the heart that may be causing the irregular electrical activity.
When an Afib patient’s heart rate is too fast, they may require medications to control the rate. Others may have a heart rate that is too slow and may require a pacemaker. A pacemaker is implanted under the chest wall and has wires or leads that connect to the inside of the heart. It provides electrical impulses to ensure the heart rate is adequate for the patient. Atrial fibrillation treatment should always include educating the patient or caregivers on lifestyle and exercise modification that may help alleviate symptoms.
Patients living with Afib are at increased risk of stroke. The physician may prescribe medication that slows the clotting of blood to reduce this risk. Patients and caregivers should recognize the signs and symptoms of a stroke and the importance of taking medications as prescribed to reduce their risk.