ATRIAL FIBRILLATION

When normal heart rhythm (sinus) is lost, it causes arrhythmia. Atrial fibrillation (AF) is the most common type of arrhythmia and it is caused when in normal conditions:

  • heart rate increases or decreases.
    Heart rate refers to the speed at which the heart beats, i.e., the number of times it contracts per minute. Normally, the heart beats between 60 and 100 times per minute. Arrhythmia occurs when, under normal conditions, heart rate decreases (bradycardia) or increases (tachycardia).
  • heart rate becomes irregular.
    Heart rate refers also refers to the way the heart beats; whether they are regular or irregular. Heart rate adapts to the needs of the body at all times. This is why it speeds up when we exercise and slows down when we sleep. However, under normal conditions, it must stay regular.

Causes


Occasionally, atrial fibrillation occurs for no apparent reason, but there are times in which there is a distinct triggering cause. The following are the most common causes:

  • High blood pressure.
    The most common cause for atrial fibrillation is high blood pressure or arterial hypertension.
  • Heart diseases.
    Any heart disease (heart valve disease, chest pain or angina, heart attack, etc.) might cause atrial fibrillation.
  • Endocrine diseases.
    In some cases, it can be the result of thyroid gland disruptions or other hormonal disruptions.
  • Unknown.
    If no cause is found after performing all the necessary tests, auricular fibrillation is called idiopathic atrial fibrillation or lone atrial fibrillation. It represents up to a third of the affected population.

Not all people present the same amount of atrial fibrillation episodes, nor they experience them under the same circumstances. There are people who suffer several episodes a month and those who only experience one episode throughout their whole lives. Even so, depending on its behavior and evolution, two types of atrial fibrillation can be identified:

  • Paroxysmal.
    Episodes come and go. Their duration varies—from less than a minute to days. It is possible that paroxysmal atrial fibrillation becomes a permanent one.
  • Persistent and permanent.
    Atrial fibrillation is constant, and normal heart rate at no time reestablishes (sinus).

Symptoms

Atrial fibrillation not always causes any symptoms. In fact, it is sometimes diagnosed by chance during a routine check-up. Despite this, some common signs of discomfort are palpitation (quick and irregular heart beat) and distinct tiredness when performing daily activities.

When experiencing an atrial fibrillation episode, it is advisable to follow the recommendations below:

  • Keep calm.
    Even though the episode may cause discomfort and anxiety, it is imperative that you remain calm. Nervousness will only worsen any discomfort you already feel.
  • Do not make any modifications to the treatment.
    If it is not the first atrial fibrillation episode you experience and you were already prescribed medication to treat the disease, it is important that you do not modify the treatment since this can cause serious side effects. The pill-in-the-pocket strategy (taking two or three treatment pills when an episode is detected) should only be applied after consulting your doctor.
  • Go to the Emergency Room.
    Most episodes end shortly after, which makes it probable that, without taking any action, you suddenly get better. Otherwise, you must go to the Emergency Room. This is particularly important when other symptoms which can suggest the existence of a more serious condition—dizziness, faints or consciousness loss, shortness of breath, chest pain, or the duration of the episode extends more than usual—appear (only if it is not the first time you have experienced such an episode.)



Diagnosis


Electrocardiogram.
It is the only necessary test to diagnose atrial fibrillation. This test register electrical activity from the heart and assesses heart rate. It is a simple and painless test. The only downside to the electrocardiogram is that atrial fibrillation has to appear at the moment the test is being performed, which makes it difficult to carry out the diagnosis, especially if the discomfort only appears in short periods of time (few minutes or hours).

Holter.
This test provides a continuous electrocardiogram during a period of 24 or 48 hours. This way we can diagnose atrial fibrillation episodes of short duration or that cause no symptoms. Occasionally, a Holter test is performed to complete the electrocardiogram assessment. In any case, to carry out this test, electrodes are attached to the patient’s chest. These electrodes are connected to a recording machine that registers the patient’s heart rate in any regular day. If you feel any discomfort during this time, you must write it down on a piece of paper next to the time it occurred. This way, the doctor can identify the presence of any arrhythmias at that precise moment.

Echocardiogram.
Through this type of exploration, images from the heart in motion are painlessly obtained. It allows the verification of the heart’s shape, activity and valve condition. It also helps detect many of the heart diseases which can cause atrial fibrillation.


Complications


With proper treatment and follow-up, atrial fibrillation prognosis is good and complications rarely occur. The main complication is embolism which derives from blood accumulation in either atrium due to the heart’s inability to contract. This haven favors the formation of clots that can exit the heart, travel in the blood stream and block any artery in the body. As a consequence, that part of the body stops receiving blood and loses all function. When embolism risk is high, the patient must be treated with blood thinners or anticoagulant drugs. When the risk is low, it can be treated with aspirin (acetylsalicylic acid) or it might even not require any medication at all.

Recommendations




Monitor your blood pressure.
Blood pressure is the main cause for atrial fibrillation; therefore, it is particularly important to closely monitor it.




Restrict alcohol intake.
Alcohol can unleash a series of atrial fibrillation episodes. Even some people only experience episodes after large alcohol intakes. It is always advisable to reduce alcohol consumption. However, you should consult your doctor on alcohol consumption if you suffer from another heart disease. Alcohol might be absolutely contraindicated.




Restrict the use of stimulants.
Coffee, tea, cola, etc. are stimulants capable of causing atrial fibrillation, which is why their consumption should be avoided or reduced.




Quit smoking.
Tobacco is always harmful to your health and it is particularly damaging for people with atrial fibrillation because it contains stimulants—like nicotine—which might lead to an episode. Quitting smoking is optimal to reduce the amount of atrial fibrillation episodes as well as the chances of suffering other cardiovascular diseases—heart attack, ictus, etc.—or non-cardiovascular diseases—several types of cancer. In order to overcome addiction much more easily, it is advisable to consult a cardiologist or your primary care provider. At many health centers, there are specialized tobacco units which can be helpful.




Exercise moderately.
Intense and extended exercise can diminish atrial fibrillation treatment efficacy, and it can increase the risk of recurrence. This does not mean you have to start a sedentary life. Walking every day and movement are essential, but you must avoid long-distance races, long bike rides and sports that entail large amounts of cardiovascular effort.




Travel cautiously.
Traveling is no downside, especially when episodes are under control. However, when planning a trip it is important to take the following aspects into consideration:

Carry all your medication with you. It is advisable to estimate the total amount of pills you have to take and bring an additional box of medication in case some go missing.

Confirm your medical appointments. When your trip falls on the same date as your medical appointment, you must inform your haematologist in advance in order to make any necessary modifications to your trip. Besides, if you are traveling for a long time—more than a month—you must foresee that, perhaps, you will need to monitor your condition at some point during your trip.



Welcome

Register Now | Forgot Password?

Forgot Password

Please enter your username or email address. You will receive a link to create a new password via email.

Subscribe to Newsletter