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Atrial Fibrillation

Related Link: MAZE Procedure for Treatment of Atrial Fibrillation

Atrial fibrillation (also called AF or A Fib) is an arrhythmia characterized as irregular, disorganized, electrical activity of the upper chambers (atria) of the heart. The atria quiver instead of regularly beating which causes them to move around 300-600 times a minute (instead of 60-80 times a minute). Because the upper chambers are quivering so rapidly, the blood is not allowed to completely empty and causes pooling in the atria.

A normal heartbeat is triggered by an electrical impulse which starts in the Sinoatrial (SA) Node. The impulse then travels across the Atrioventricular (AV) Node and triggers the ventricles to contract.

Atrial fibrillation has three stages:

  1. Paroxysmal AF consists of short episodes of this arrhythmia, which often spontaneously reverts to a regular rhythm.
  2. Persistent AF is when the arrhythmia requires intervention to return to a normal rhythm.
  3. The AF is considered permanent when intervention fails or the intervention returns the heart to a regular rhythm for only a brief time.

Atrial fibrillation is the most common arrhythmia found in adults. AF affects approximately 2 million Americans and the number of new cases of the arrhythmia is likely to increase as an increasingly larger fraction of the population reaches geriatric age. The incidence of AF increases rapidly with age and the prevalence is between 4% and 16% in people older than 70 years. Atrial fibrillation can involve as many as 40% of patients with congestive heart failure. AF is present in close to 50% of all patients undergoing surgery for mitral valve disease.

What are some of the Causes and Risk Factors for Atrial Fibrillation?

It is often difficult to identify the precise cause of atrial fibrillation. Coronary artery disease, high blood pressure, disease of the heart valves are associated with AF. Some normal hearts can be influenced by stress, excessive alcohol, caffeine, infections. Sometimes, no underlying cause is identifiable.

What are Common Symptoms of Atrial Fibrillation?

Approximately 30% to 60% of patients experience symptoms associated with AF. Some of the common symptoms could include palpitations, a sudden fluttering or pounding in the chest. Sometimes, because the heart is not pumping adequately during AF, the symptoms may include dizziness, shortness of breath, and feeling faint.

How is Atrial Fibrillation Diagnosed?

A physician can usually detect AF by listening to the heart with a stethoscope or taking a pulse at the wrist. To confirm the rhythm, an electrocardiogram (EKG) typically will be performed in the doctor’s office. If the AF is intermittent, it may be necessary to wear a holter monitor (a portable continuous EKG recorder) for extended periods of time to catch an episode of AF.

How is Atrial Fibrillation Treated?

It has been inherently likely that conversion to and maintenance of a regular rhythm might have a favorable impact on quality of life, symptoms from AF, and the risk of stroke. Therefore one of several treatment options for AF should be considered. The first line of treatment usually involves medications, but there are other treatments which may be appropriate. Currently the treatment choices include:

  1. medications
  2. cardioversion
  3. AF suppression
  4. ablation


Related link: MAZE Procedure for treatment of atrial fibrillation


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