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Causes, signs, and management of atrial fibrillation

Causes, signs, and management of atrial fibrillation

A type of arrhythmia, atrial fibrillation (AFib), is an unsteady heartbeat that can disrupt blood flow, resulting in palpitations, chest pain, and shortness of breath. Here, one is at a higher risk of blood clots and stroke. AFib causes the two upper chambers of the heart (atria) beat out of coordination with the two lower chambers (ventricles). It can develop as a chronic condition, or one may experience sporadic episodes.

Causes and risk factors
The main cause for the development of atrial fibrillation is the improper electrical signaling between the chambers of the heart, which prevents them from coordinating as they should. The atria and ventricles typically contract at the same rate. However, with AFib, the upper chamber contracts rapidly and erratically, which disrupts the regular rhythm. Certain factors, like age, European ancestry, and high body mass, can increase the risk of developing atrial fibrillation. Further, health issues like high blood pressure, diabetes, pulmonary embolism, heart attack, an ischemic heart condition, hyperthyroidism, sleep apnea, and long-term kidney disease are common risk factors. An increase in the size of chambers on the left side of the heart can also increase the risk.

Signs
Sometimes, those with AFib do not exhibit any symptoms. If the ventricles are palpitating normally or somewhat quicker, one probably would not notice a difference. But if the ventricles start to beat faster, one will experience observable symptoms. Here are a few signs of AFib:

  • Feeling extremely tired
  • An unsteady heartbeat or palpitations
  • A racing heart rate
  • A strange sensation in the chest (butterflies)
  • Lightheadedness or dizziness
  • Syncope (fainting)
  • Dyspnea (shortness of breath)
  • Angina (chest pain)
  • Exercise intolerance


Treatment options

Doctors usually customize the treatment plan as per each patient’s age, lifestyle, heart health, and overall health. One may have to undergo a combination of therapies to deal with AFib. The treatment options aim to reduce the risk of getting stroke and blood clots, ease vascular muscles and lower heart rate, and make the contractions stronger. Here are the common procedures doctors may recommend:

Electrical cardioversion: Here, the surgeon will shock the heart with coordinated electricity to restore the regular rhythm. They might perform transesophageal echocardiography before cardioversion to obtain an image of the heart by inserting an endoscope. This helps doctors check for clots and treat them first before proceeding with cardioversion.

Catheter ablation: Here, radio waves destroy the tissue responsible for the erratic heartbeat. If AFib recurs, the surgeon might have to repeat this procedure.

Surgical ablation: Through a treatment known as a maze operation, surgeons can remove the cardiac tissue responsible for the abnormal heartbeat.

Pacemaker placement: A pacemaker is a medical device that tells the heart how often to beat. In some cases, a surgeon will remove the native electrical system and implant a pacemaker in a patient with intermittent AFib. The device then “takes over” to restore regular heartbeats.

AFib is a common issue that is expected to affect about 12.1 million people in the country by 2030. However, recognizing the warning signs and risk factors can help one seek timely treatment and prevent further complications.