Atrial Fibrillation is an emergency medical condition characterized by irregular and usually rapid heart rhythm. It primarily affects the atria, which are the 2 upper chambers of the heart. The arrhythmia (irregular rhythm) is caused by abnormal electrical impulses in the heart due to lack of coordination in atrial activity. As a result, Atrial Fibrillation often leads to more serious medical conditions such as Congestive Heart Failure and Stroke. The normal heart rate for adults is between 60-100 beats per minute. A person with Atrial Fibrillation is tachycardic (the heart rate is above the normal range) and could go as high as having 500-600 beats per minute.
Statistically, AFib is the most frequently diagnosed type of arrythmia. It affects an average of about 2 million in the United States alone although this type of arrhythmia is usually non-life threatening. The risk of suffering from this condition gradually increases with age since 8% of people above 80 have Atrial Fibrillation.
Atrial Fibrillation Classifications
1. Paroxysmal – Episodes usually last for less than 24 hours but could last up to a week.
2. Persistent – Episodes are more current and last for more than 7 days. Medical attention is needed to temporarily terminate the episode.
3. Permanent – There is constantly on-going, and long term Atrial Fibrillation.
4. Lone – Atrial Fibrillation in people with no cardiac or pulmonary structure abnormalities with only one diagnosed episode.
Clinical Manifestations are as follows, though it may differ from person to person:
* Palpitations (most common)
* Light Headedness
* Exercise Intolerance
* Shortness of Breath
* Easy Fatigability
During initial assessment, it is best to know which ones need immediate medical attention. Those who need urgent care are the ones who manifest Hypotension and Uncontrolled Angina. Less severe symptoms are the ones mentioned above.
In some cases, Afib occurs as a result of other underlying medical conditions not related to the heart. Some of these non-cardiac causes are Hyperthyroidism, Pulmonary Embolism and Pneumonia. But most of the time, this condition is caused by other heart-related diseases like Angina Pectoris, Hypertension, Rheumatic Fever, Pericarditis, and Coronary Artery Disease. Sometimes, Atrial Fibrillation may take place a few days or weeks post-heart surgery. Alcoholism can also contribute to gradually developing the condition.
Diagnostic tests are performed to confirm the presence of Atrial Fibrillation. Some of these are:
Thyroid Stimulating Hormone (TSH)
* Prothrombin Time (PT)
* Electrocardiogram (ECG) – The most definitive, characterized by the absence of P waves upon exam.
* 2D Echocardiography (2D Echo)
* Holter Monitor – 24-hour ECG monitoring.
* Cardiac Stress Test
When treating afib, the main objective is to prevent circulatory instability, then helping promote proper oxygenation. Cardioversion is the most common initial treatment. It is the process of converting an abnormally fast or irregular hearth rhythm to normal sinus rhythm. Cardioversion can either by synchronized or chemical. The former makes use of a therapeutic dose of electrical shock to the heart while the litter makes use of a pharmacologic regimen. Administration of anticoagulants like aspirin, heparin, and warfarin are also done. Intravenous Magnesium can also be given to significantly increase the chances of successful rate and rhythm control with rare side effects. Other drugs like beta blockers (metoprolol, propanolol), calcium channel blockers (amlodipine, nifedipine), and Cardiac Glycosides (digoxin) are also given to help control the heart rate – thus preventing complications caused by Atrial Fibrillation.