What is atrial fibrillation?
Atrial fibrillation consists of an alteration of the heart’s electrical system that causes the heart to beat irregularly instead of regularly and also at a higher than usual heart rate, hence the symptoms it can produce such as palpitations, shortness of breath and chest pain. It must be said that it is the most frequent arrhythmia and that it involves a series of important health problems. In fact, it can occur in both young and old people, and in the latter it is much more frequent, occurring in more than 20% of people over 80 years of age.
What are the causes of arrhythmia?
The most frequent cause of atrial fibrillation is hypertension itself, the changes that long-term hypertension produces in the structure of the heart and in the electrical system of the heart. In addition there are other heart diseases that can produce atrial fibrillation more or less frequently. Also other conditions that have nothing to do with the heart such as thyroid, excess alcohol intake, lung diseases or abuse of stimulant substances can also produce atrial fibrillation and should be known. It is also not uncommon to see it in young people in whom the heart is apparently normal, we do not apparently detect anomalies and it is something that we are seeing more recently in competitive athletes due to the effect of very aggressive training on the heart itself, which produces changes in the left atrium and can lead to atrial fibrillation, which should also be treated as when it is associated with other heart diseases.
What is the risk and which patients should be followed up?
The main risks of atrial fibrillation are of two types, one is the fact that when the arrhythmia occurs, the heart beats faster, which can trigger heart failure, especially in patients who already have an underlying heart disease, which manifests itself as shortness of breath and requires timely treatment, not only for atrial fibrillation but also for heart failure. On the other hand, probably the most frightening problem is that of embolisms, mainly cerebral, also called strokes, which are due to the fact that atrial fibrillation can produce clots inside the heart, which we call thrombi, these clots can break loose from the heart and block an artery in the brain. At that moment a cerebral embolism can occur and this is probably the most frightening consequence and the one we must always treat in these patients.
How is atrial fibrillation treated?
Atrial fibrillation has 2 fundamental parts in its treatment, one is to give anticoagulant treatment to prevent cerebral embolisms, usually Sintron is used, and secondly the treatment of the arrhythmia itself, in some cases we will consider removing the arrhythmia to restore the normal rhythm of the heart and this is usually done by electrical cardioversion which consists of the application, using blades, of electrical energy on the heart in such a way that in a significant number of cases we can return the normal rhythm to the heart. If it is ineffective we can also consider a slightly more aggressive technique which is radiofrequency ablation, which consists of inserting catheters into the heart and burning the area where the arrhythmia occurs in such a way that if it is effective, in many cases we can cure the patient. In cases where all this has been ineffective, we must be satisfied with controlling the patient’s heart rate, even if the patient has a chronic arrhythmia, we will control the heart rate well and there should be no long-term problems.