Atrial Fibrillation (AFib)
What is Atrial Fibrillation (AFib)?
Atrial fibrillation is an abnormal rhythm of the heart. It is relatively common, affecting about 50 million adults worldwide. The prevalence increases with age, and most people who develop A-fib are over 65 years of age.
In atrial fibrillation (A-fib), the upper chambers of the heart (the atria) do not work correctly because of abnormal electrical activity. This means that blood is not moved from the atria to the ventricles (lower chambers of the heart) as effectively as it should be. This can cause people to feel unwell. The blood that remains in the atria does not move as quickly as normal, which allows blood clots to form. Blood clots that form in the left atrium can leave the heart and travel to the brain, resulting in a stroke.
What are the risk factors?
- 1. Age over 65 years
- 2. Underlying heart disease. (E.g. hypertensive heart disease, heart attack, heart failure, heart valve disease, a complication of heart surgery etc.)
- 3. Alcohol and binge drinking
- 4. Hyperthyroidism
- 5. Medications (Drugs that stimulate the heart can contribute to the development of A-fib. An example is theophylline)
- 6. Sleep apnea (breathing problems while sleeping).
- 7. Chronic obstructive pulmonary disease (COPD)
- 8. Obesity
- 9. Diabetes
- 10. Chronic kidney disease
What are the symptoms?
- 1. Unpleasant palpitations or irregularity of the heart beat
- 2. Mild chest discomfort (sensation of tightness) or pain
- 3. A sense of the heart racing
- 4. Lightheadedness
- 5. Mild shortness of breath and fatigue, especially with exercise
- 6. Some people have severe symptoms, such as:
- a. Difficulty breathing (with exertion, exercise, or at rest)
- b. Fainting, or near fainting, due to a reduction in blood flow to the brain
- c. Chest pain
- d. Severe fatigue
- • Balance – Difficulty standing or walking
- • Eyes – Changes in vision
- • Face – Sudden weakness or droopiness of the face, or problems with vision
- • Arm – Sudden weakness or numbness of one or both arms
- • Speech – Difficulty speaking, slurred speech, or garbled speech
- • Time – Time is very important in stroke treatment. The sooner treatment begins, the better the chances are for recovery. If you notice any of the above signs, call for an ambulance right away.
What are the diagnostic tests?
- ECG or EKG
- Echocardiogram (ultrasound)
What is the treatment?
There are two types of treatments to reduce the risk of stroke and other problems from blood clots in people with A-fib:
- Taking an anticoagulant medication reduces your risk of stroke.
- There are also non-medication options for the prevention of stroke.
- Anticoagulant drugs — Anticoagulants (sometimes called “blood thinners”) are the most effective treatment for preventing blood clots in people at high risk of stroke. Taking an anticoagulant medication can reduce the risk of having a stroke by approximately 50 to 70 percent.
- Medication – For people with A-fib, the most common way to control the heart rate is by taking a medication (a beta blocker, calcium channel blocker, or, less commonly, digoxin)
- AV node ablation – Ablation of the atrioventricular (AV) node combined with implantation of a pacemaker is a method of rate control without using drugs. This method may be used when rate control drugs and rhythm control have not worked.
How to reduce risk of bleeding?
- 1. Use a soft bristle toothbrush.
- 2. Use a humidifier to help reduce nosebleeds (if you live in a cold or dry climate).
- 3. Use caution when handling sharp objects (eg, knives).
- 4. Avoid activities that could result in injury (eg, contact sports).
- 5. Use appropriate safety equipment (eg, helmets, padding) during physical activity.
- 6. Avoid aspirin or other nonsteroidal anti-inflammatory agents (NSAIDS); unless your health care provider tells you to take them.
- 7. Wear an alert tag.
