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Common Name:


ATRIAL FIBRILLATION (AF)

Medical Term: None Specified
Description:

A completely irregular heartbeat (arrhythmia), arising from the hearts upper chamber (atrium), and conducted downwards to the hearts main chambers (ventricles) causing the ventricles to contract faster and less efficiently than normal.

Atrial fibrillation is the most frequent form of serious cardiac arrythmia. It's incidence varies from 1% before age 60 to 20% at age 80. It is twice as common in men as in women.

Abnormal rhythms may occur sporadically or may persist.

Causes:

The heart may go into atrial fibrillation without any underlying heart disease. However, the probability of AF increases dramatically when cardiovascular disease is present. AF can also occur with non-cardiovascular problems.

Outlined are underlying causes: Atherosclerosis of coronary arteries, with or without a previous heart attack;Hypertension (high blood pressure); Hyperthyroidism; Congestive heart failure; Rheumatic heart disease caused by rheumatic fever; Stress related; Chronic lung disease; Alcoholism.

Prevention:

Stop smoking and reduce alcohol intake. Follow suggestions under Diet. Children and young adults of parents with this condition may benefit from a low-fat diet. Some symptoms can be controlled with medications.

Signs & Symptoms

Continuously irregular heartbeat, in which no 2 beats are of equal strength or duration.

No symptoms (sometimes).

Palpitations

Chest pain

Shortness of breath

Weakness, dizziness or faintness (sometimes).

Black out spell (syncope)

Stroke

Risk Factors

Stress.

Recent surgery.

Electrolyte disturbances, especially low potassium.

Pulmonary embolism.

Excessive use of some drugs, such as thyroid hormones, caffeine and others.

Smoking.

Excess alcohol consumption.

Excessive weight.

Diagnosis & Treatment

Diagnostic tests include electrocardiogram and blood studies to measure levels of drugs used in treatment, to check electrolytes and rule out thyroid disorder.

General Measures:

In a substantial number of patients AF reverts to normal rhythm in 24 hours.

Hospitalization (sometimes).

Electric shock (electro-cardioversion), which may restore normal rhythm.

Have family members and friends learn cardiopulmonary resuscitation (CPR) in case you have cardiac arrest.

Don't smoke and don't drink more than 1 or 2 alcoholic drinks, if any, a day.

Learn to check your own pulse for rate and rhythm.

Minimize stress.

Avoid non-prescription decongestants.

Additional information available from the American Heart Association, local branch listed in telephone directory or call (800) 242-8721 or from the Canadian Heart Association.

Medications:

Heart medications, such as digitalis, quinidine, calcium-channel blockers or beta-adrenergic blockers to regulate the heartbeat.

Anticoagulants to prevent blood clot (you will need regular blood tests to monitor the effect of the anticoagulants).

If all other treatments fail, the atrio-ventricular node can be destroyed by catheter ablation ( a catheter is inserted into the heart and AV node is destroyed using radio-frequency energy).

Activity:

Resume your normal activities as symptoms improve.

A regular exercise program is recommended.

Diet:

Lose weight if you are obese, but don't use appetite suppressants.

These may worsen rhythm disturbances.

The underlying heart condition may require a low-salt or low-fat diet and potassium supplements.

Possible Complications :

Arterial thrombosis or embolus, which if dislodged can cause stroke.

Acute pulmonary edema.

Congestive heart failure.

Other heartbeat irregularities that could trigger cardiac arrest.

Bleeding complications from anticoagulant therapy.

Prognosis

Atrial fibrillation is a common problem, with substantial morbidity. Thromboembolism prevention is the best way to improve the prognosis.

A normal heartbeat rhythm can be restored with electro-cardioversion in about 50% of patients. In the other 50%, heart rate can be controlled with medications. However, there is a high recurrence rate even after treatment.