What is atrial fibrillation?
Atrial fibrillation is a fast and irregular heart rate that increases the risk of various heart-related pathologies, such as stroke, heart failure, etc.
Atrial fibrillation is the most common type of arrhythmia, and is caused by an electrical problem in the heart. It occurs when there is an irregular and usually accelerated heart rate, which occurs when the two atria – upper chambers of the heart – have electrical signals that are considered chaotic.
As a result of these chaotic signals, the chambers become agitated, and the atrioventricular node – the connection between the atria and ventricles – receives a large number of impulses that try to reach the ventricles, which will also beat in an accelerated manner, although not as fast as the atria.
The result is an accelerated and irregular heart rhythm, with a rate varying between 100 and 175 beats per minute, the normal range being between 60 and 100 per minute.
Prognosis of the disease
Occasionally, atrial fibrillation may result in the following:
- Stroke: in atrial fibrillation the chaotic heart rhythm can cause blood to pool in the atria, i.e. the upper chambers of the heart, forming clots. If a blood clot forms, it can break away from the heart and travel to the brain, potentially blocking blood flow and causing a stroke. This risk of stroke in atrial fibrillation varies depending on age, whether the person has high blood pressure, diabetes…
- Heart failure: Atrial fibrillation can weaken the heart causing heart failure, which prevents the heart from circulating enough blood to make the body function properly.
Symptoms of atrial fibrillation
Sometimes, atrial fibrillation may be asymptomatic, and it is not discovered until a physical examination is carried out. If symptoms are present, they are as follows:
- Palpitations
- Weakness
- Fatigue or a feeling of fatigue
- Decreased capacity for physical exercise
- Dizziness
- Lightheadedness
- Confusion
- Shortness of breath
- Chest pain
It should be noted that atrial fibrillation can be occasional, persistent, persistent and long-term or permanent.
- Occasional: it is known as paroxysmal atrial fibrillation, and may have intermittent symptoms that can last from minutes to several hours and disappear on their own.
- Persistent: in this type of atrial fibrillation, the heart rhythm does not return to normal on its own. In this case, treatment such as electric shocks or medications that restore the cardiac system to normal will be needed.
- Persistent and long-term: this type of atrial fibrillation is continuous in nature, and its duration extends beyond twelve months.
- Permanent: in this type of atrial fibrillation, normal heart rate cannot be achieved or restored. In these cases, the patient will have atrial fibrillation permanently, and medication will usually be needed to control the heart rate.
Medical tests for atrial fibrillation
To make a diagnosis of atrial fibrillation, the specialist will review the patient’s medical history and perform a physical examination. Different tests may be requested to make a definitive diagnosis:
- Electrocardiogram: through electrodes, the electrical signals that pass through the heart are recorded.
- Holter monitor: this device carried in the pocket records the heart’s activity for a full day. The physician can make an exhaustive observation.
- Episode recorder: activity is monitored over a period that can range from weeks to months. It should be activated only when symptoms are felt, recording the activity of the minutes before and after.
- Echocardiogram: this is a non-invasive test that uses sound waves to generate a video image of the heart.
- Blood tests
- Stress test
- Chest X-ray
What are the causes of atrial fibrillation?
The presence of abnormalities or lesions in the structure of the heart is the most common cause of atrial fibrillation. Some of the causes of atrial fibrillation include the following:
- High blood pressure
- Heart attacks
- Coronary artery disease
- Abnormally sized heart valves
- Congenital heart disease
- Metabolic imbalances
- Pulmonary diseases
- Previous heart surgeries
- Viral infections
- Stress
- Sleep apnea
Prevention of atrial fibrillation
The best way to prevent fibrillation is to maintain a healthy lifestyle to avoid the risk of heart disease. Some of the guidelines to follow are:
- Follow a healthy, balanced diet
- Increasing physical activity
- Maintain a stable and adequate weight
- Avoid smoking
- Avoid or limit consumption of alcoholic beverages and caffeinated beverages.
- Reducing stress
Treatment for atrial fibrillation
To treat atrial fibrillation, it is necessary to follow three guidelines: control the rate and restore the rhythm, prevent clots and reduce the risk of stroke.
- Restoring the heart rhythm: this is done through a process called cardioversion. There are two types, electrical cardioversion and cardioversion with drugs.
- Maintenance of a normal heart rhythm: these are anti-arrhythmia drugs that can prevent episodes of fibrillation in the future, although they can cause side effects such as nausea, dizziness and fatigue.
- Heart rate control: medications with the ability to control the heart rate may be prescribed.
Surgical procedures are also available to treat fibrillation.
- Catheter ablation: long, thin tubes are inserted through the groin and guided through the blood vessels to the heart. Electrodes on the catheters may use cold or heat to heal the erratic signals, correcting the arrhythmia.
- Maze surgical procedure: This procedure is performed during open heart surgery. Incisions are made to create a pattern of scar tissue. Because it is open heart surgery, it is reserved for people who have not responded to other treatments.
- Atrioventricular Node Ablation: This is used when catheter forms of ablation and medications do not work.
Which specialist treats atrial fibrillation?
The specialist in charge of studying and treating fibrillation is the Cardiologist.