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Atrial Fibrillation - Causes, Symptoms & Treatment


What Is A-fib Symptoms Causes Diagnosis Treatment

What is Atrial Fibrillation?

Arial Fibrillation is the most common type of abnormal heart rhythm.  It affects millions of people around the world each year.  Atrial Fibrillation is often referred to as ‘A-fib’ and is a very fast and disorganized heartbeat that occurs in the upper chambers of the heart known as the atria.  During A-fib, the heart beat is irregular and can beat more than 2000 beats per minute.  The atria beats so fast and irregularly that it appears to quiver or ‘fibrillate.’

What are the Symptoms and Dangers of Atrial Fibrillation?

This rapid, chaotic, and irregular heart beat can result in symptoms that include fatigue, weakness, shortness of breath, palpitations, chest discomfort, and dizziness.  It should be noted that some people with A-fib do not experience any symptoms at all.  Regardless, anyone with this condition – with or without symptoms – is at risk of one of its most dangerous side effects…stroke.

What Causes Atrial Fibrillation?

The exact cause of A-fib is difficult to determine but we know there are certain contributing risk factors including hypertension, diabetes, obesity, and alcohol use.  Additional risk actors are structural abnormalities of the heart, such as heart valve disease, coronary artery disease, previous heart attaches, and congestive heart failure.  Thyroid abnormality, pneumonia, pulmonary embolism and recent heart surgery might cause A-fib.  In these cases, A-fib may resolve with treatment of the underlying cause.

The incidence of A-fib rises sharply with age.  Estimates are that as many as 2 percent of all Americans are currently experiencing atrial fibrillation and that up to 20 percent will experience it during their lifetime.

How is Atrial Fibrillation Diagnosed?

The first step in diagnosing A-fib is a thorough medical history and physical exam.  Your doctor will need to know about your symptoms and will ask you to share when your symptoms began, how long they last, and how they make you feel.  In addition, your doctor may choose to use tests to diagnose your condition including one or more of the following:

  • Electrocardiogram (ECG or EKG): An electrocardiogram is a simple test that records your heart’s electrical activity.  Electrodes (sticky patches) are placed on the chest, arms, and legs and connected to a machine that records the electrical activity of the heart.  A recording of that electrical activity is printed out and the report is interpreted by a physician.

  • Electrophysiology (EP) Study:  An EP study is performed by an electrophysiologist – a cardiologist who specializes in heart rhythm disorders – and can help confirm the type of rhythm problem you have.  It is a minimally invasive procedure that usually takes place under light sedation.  Electrode catheters introduced through a blood vessel are used to stimulate the heart with electrical impulses.  The electrical activity of your heart during the test is recorded and that is used to determine the best treatment options.

  • Holter Monitor: A Holter Monitor is a small portable device that makes a recording of your heart’s electrical activity over an extended period of time – 24 to 48 hours.  This information can be used to detect a rhythm problem that may occur intermittently.

How can Atrial Fibrillation be Treated?

At Suburban Hospital, in the Orkand Center for Interventional Cardiology, A-fib can be treated in a number of ways, depending on the cardiologist’s recommendation and a patient’s response to treatment:

  • Medications such as amiodarone, digoxin, and beta blockers such as atenolol or metoprolol can be used.

  • Blood thinners also may be prescribed to prevent clots. 

  • Electrical cardioversion employs a gentle electric shock to correct the abnormal heart rhythm.

  • Catheter ablation uses catheters (thin tubes) threaded into the heart to make a little scar in the tissues causing the A-fib to black the bad rhythm.

  • Operative ablation (MAZE procedure) is performed on patients having open heart surgery.

Suburban Hospital is one of the few hospitals in the Greater DC and Maryland area equipped for doing complex catheter ablation procedures.  During catheter ablation, catheters are inserted into a blood vessel in the legs and then threaded up into the heart.  Using fluoroscopy, heat is used to destroy the sites where the rapid heartbeats originate.  Complex catheter ablation has numerous advantages:

  • It can permanently interrupt the triggers of heart arrhythmia, so many patients require no further treatment.

  • It can restore a regular, coordinated heartbeat to a normal rate.

  • For many patients, it brings freedom from long-term use of blood-thinning medications.

  • It is minimally invasive and no open-heart surgery is needed.

  • There is reduced risk to the patient, as compared to surgery.

  • The patient typically has little or no pain.

  • Recovery is relatively fast; most patients leave the hospital after one or two days and resume normal activities a few days after the procedure.

At Suburban Hospital, our electrophysiologists (specialized interventional cardiologists) use three imaging techniques during cardiac ablation: 

  • State-of-the-art three-dimensional electroanatomical mapping that tracks the position of the catheters within the “shell” of the heart, records the electrical activity of the heart, and shows where heat was used to ablate the rapid heartbeats.

  • Fluoroscopy, which is used to view the catheters under X-ray, and

  • Intracranial ultrasound, to image the interior of the heart and to provide another real-time visual of the catheters in the heart.

 Click here to find one of Suburban Hospital’s highly trained cardiac specialists.