What is atrial fibrillation?
A heart that beats in regular intervals is said to be in normal sinus rhythm. Atrial fibrillation (a-fib) is an abnormal heart rhythm that causes the two upper chambers of the heart, the atria, to quiver instead of contracting. This happens because the electrical signals that regulate the atria become erratic and start firing at 300 to 400 times per minute, resulting in a fast, irregular rate in the lower chambers that can in turn lead to severe symptoms. The triggers for atrial fibrillation are usually found in the pulmonary veins, which drain oxygenated blood from the lungs into the left atrium.
Why is a-fib a problem?
When the upper chambers of the heart beat too fast or uncontrollably, blood may pool in the left atrial appendage and form clots, increasing the risk for stroke. About 15 percent of strokes occur in people with a-fib. In addition, if you have a-fib, you may not feel well because your heart is unable to pump effectively.
What are the risk factors for a-fib?
- existing heart disease
- heart surgery
- family history (genetics)
- obstructive sleep apnea
- lung disease
- high blood pressure (hypertension)
- thyroid problems
- alcohol consumption
What are the symptoms of a-fib?
- palpitations (the feeling of a rapid, fluttering or pounding heartbeat)
- low blood pressure (hypotension)
How is a-fib diagnosed?
- electrocardiogram (EKG or ECG)
- ambulatory monitoring (Holter monitor or event recorder)
- echocardiogram (an ultrasound of the heart)
- stress test
- blood work
- CT or MRI scan
What are the treatments for a-fib?
Beaumont's Atrial Fibrillation clinics offer specially trained, multidisciplinary teams that provide the most advanced, innovative treatment approaches, including:
- Medications - this is the first line of treatment for a-fib. Your physician will determine the best medication for you to control the heart rate, prevent episodes of atrial fibrillation and prevent stroke based on your individual risk.
- Electrical cardioversion - a procedure in which an electrical shock restores normal sinus rhythm
- Pulmonary Vein Isolation (PVI) - a procedure where pulmonary veins are electrically isolated from the rest of the atrium, preventing the triggers of atrial fibrillation from taking over the heart.
- WATCHMAN™ implant very effective in patients with non-valvular atrial fibrillation as an alternative to long-term warfarin medication
- an effective surgical treatment for a-fib that also aims to electrically isolate the pulmonary veins from the rest of the atrium. Patients are candidates for a MAZE procedure if their irregular heartbeat cannot be treated with medication or other nonsurgical approaches.
- robotic MAZE: five tiny incisions
- traditional open heart maze surgery
- AV node ablation - another option for patients who are severely symptomatic, but are not good candidates for alternative procedures. A pacemaker is always inserted after this procedure.
- Pacemaker implantation - very effective in patients with very slow heart rates and difficult to control atrial fibrillation.