Atrial Fibrillation
From Richard N. Fogoros, M.D,
The Basics
Atrial fibrillation is one of the most common of the heart rhythm disturbances. While it is a benign arrhythmia, the lack of highly effective and safe therapies makes it one of the most frustrating of arrhythmias to deal with for both patients and doctors.
In these articles, we will review the causes, symptoms and diagnosis of this arrhythmia, but our main goal is to simplify the confusing array of options for treating atrial fibrillation.
What is atrial fibrillation?
Atrial fibrillation is a rapid and highly irregular heart arrhythmia, caused by chaotic electrical impulses in the atria of the heart. The AV node are therefore bombarded with frequent, irregular electrical impulses.
What causes atrial fibrillation?
Atrial fibrillation is associated with underlying valvular heart disease, longstanding hypertension, coronary artery disease, alcohol use, hyperthyroidism, pericarditis, cardiac surgery, heart attack, and virtually all other varieties of heart disease. When an underlying cause can be identified, then often, treating that underlying cause also improves the atrial fibrillation. In many patients, no particular underlying cause for atrial fibrillation can be identified, in which case the atrial fibrillation is said to be “idiopathic.”
When idiopathic atrial fibrillation is seen in younger patients, the term “lone atrial fibrillation” is frequently used. This term reflects the fact that no identifiable cause for the arrhythmia is present, so it is the “lone” abnormality present. What are the symptoms of atrial fibrillation, and how dangerous is it? The symptoms of atrial fibrillation are related to the rapid heart rate, and to the loss of coordination between the atria and ventricles. People who have atrial fibrillation often complain of palpitations, easy fatigability, shortness of breath, and (occasionally) lightheadedness. In addition, people with underlying coronary artery disease can develop angina from the rapid heart rate; and people with underlying cardiomyopathy can have an acute episode of heart attack.
Possibly the biggest problem with atrial fibrillation is that, if the arrhythmia is sustained for a day or two, the ineffective pumping action of the atria (caused by the chaotic electrical activity) allow blood clots to form. If these blood clots break off and get into the bloodstream, a stroke can result. Thus, patients who are in prolonged or chronic atrial fibrillation have a significantly increased risk of stroke.
How is atrial fibrillation diagnosed?
Atrial fibrillation is easy to diagnose in patients who are having the arrhythmia at the time they visit the doctor. A simple electrocardiogram (ECG) will reveal the diagnosis in virtually all such patients. However, many patients with atrial fibrillation have transient episodes lasting from minutes to hours. These patients will generally complain of the sudden episodes of palpitations and perhaps shortness of breath. If the episode has ended by the time they receive medical attention, no sign of atrial fibrillation will be found. In these patients, some form of outpatient monitoring is necessary to make a diagnosis.
The Basics
Atrial fibrillation is one of the most common of the heart rhythm disturbances. While it is a benign arrhythmia, the lack of highly effective and safe therapies makes it one of the most frustrating of arrhythmias to deal with for both patients and doctors.
In these articles, we will review the causes, symptoms and diagnosis of this arrhythmia, but our main goal is to simplify the confusing array of options for treating atrial fibrillation.
What is atrial fibrillation?
Atrial fibrillation is a rapid and highly irregular heart arrhythmia, caused by chaotic electrical impulses in the atria of the heart. The AV node are therefore bombarded with frequent, irregular electrical impulses.
What causes atrial fibrillation?
Atrial fibrillation is associated with underlying valvular heart disease, longstanding hypertension, coronary artery disease, alcohol use, hyperthyroidism, pericarditis, cardiac surgery, heart attack, and virtually all other varieties of heart disease. When an underlying cause can be identified, then often, treating that underlying cause also improves the atrial fibrillation. In many patients, no particular underlying cause for atrial fibrillation can be identified, in which case the atrial fibrillation is said to be “idiopathic.”
When idiopathic atrial fibrillation is seen in younger patients, the term “lone atrial fibrillation” is frequently used. This term reflects the fact that no identifiable cause for the arrhythmia is present, so it is the “lone” abnormality present. What are the symptoms of atrial fibrillation, and how dangerous is it? The symptoms of atrial fibrillation are related to the rapid heart rate, and to the loss of coordination between the atria and ventricles. People who have atrial fibrillation often complain of palpitations, easy fatigability, shortness of breath, and (occasionally) lightheadedness. In addition, people with underlying coronary artery disease can develop angina from the rapid heart rate; and people with underlying cardiomyopathy can have an acute episode of heart attack.
Possibly the biggest problem with atrial fibrillation is that, if the arrhythmia is sustained for a day or two, the ineffective pumping action of the atria (caused by the chaotic electrical activity) allow blood clots to form. If these blood clots break off and get into the bloodstream, a stroke can result. Thus, patients who are in prolonged or chronic atrial fibrillation have a significantly increased risk of stroke.
How is atrial fibrillation diagnosed?
Atrial fibrillation is easy to diagnose in patients who are having the arrhythmia at the time they visit the doctor. A simple electrocardiogram (ECG) will reveal the diagnosis in virtually all such patients. However, many patients with atrial fibrillation have transient episodes lasting from minutes to hours. These patients will generally complain of the sudden episodes of palpitations and perhaps shortness of breath. If the episode has ended by the time they receive medical attention, no sign of atrial fibrillation will be found. In these patients, some form of outpatient monitoring is necessary to make a diagnosis.
posted by Heart Scan @ 11:12 PM
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