Atrial Fibrillation – Part II

Atrial fibrillation (AFib) is an irregular heartbeat that often causes the heart to beat too fast.  There are several risk factors and underlying causes, which we discussed last week, including different types of heart disease, thyroid disease, heavy alcohol use, and family history.  This week we will talk about the possible complications of AFib and how it can be prevented and treated.
What are the possible complications of AFib?
  • Stroke – Particularly the type of stroke caused by a blood clot traveling to the brain.
  • Heart Failure – The chaotic rhythm of AFib causes the chambers of the heart to be uncoordinated.  This makes it hard for your heart to pump the amount of blood that your body needs to function normally.  Early in AFib, this heart failure can be reversible by controlling the AFib.  Over time, if AFib is not controlled, it causes damage to the heart muscle and heart failure can become irreversible.
How does AFib cause a stroke?
When the upper chambers (the atria) of the heart are beating irregularly, those chambers can’t pump all of the blood to the lower chambers (the ventricles).  This leads to blood pooling in the atria.  When blood pools and is not in active circulation, it can form clots.  Blood clots formed in the heart can become dislodged and travel through the bloodstream to the brain.  Once in the brain, the clot might block blood flow, which causes a stroke.
The risk of stroke in patients with AFib depends on several factors.  There is higher risk of stroke in AFib if you also have high blood pressure, heart failure, or diabetes.  The risk also increases as you get older.
Can AFib be prevented?
We can’t prevent all AFib.  However, living a heart-healthy lifestyle reduces your risk of heart disease, which in turn helps prevent AFib.  You can also avoid some other causes of AFib.
Preventive measures include:
  • Not smoking and avoiding second-hand smoke
  • Being physically active on a regular basis, at least 150 minutes each week
  • Eating a heart-healthy diet
  • Maintaining a healthy weight
  • Limiting intake of alcohol and caffeine
  • Practicing relaxation techniques or other measures to reduce stress
  • Being cautious with OTC medications that contain stimulants.  This includes “energy” supplements and some cold and cough medications.
How is AFib diagnosed and evaluated?
  • Electrocardiogram (ECG or EKG) – Plots your heart rhythm on a special graph.
  • Holter monitor or Event monitor – Essentially an EKG that monitors your heart rhythm remotely.  You wear it for an extended period of time (24 hours up to 30 days).  These monitors can be very helpful to diagnose intermittent (paroxysmal) AFib.
  • Echocardiogram – An ultrasound of the heart, which allows your doctor to see the rhythm of the heart and will also show a blood clot within the heart.
  • Blood tests – Used to find underlying causes of AFib, such as thyroid disease.
How is AFib treated?
Treatment depends on several things, including which type of AFib your have (paroxysmal, persistent, or permanent), how bothersome your symptoms are, and the underlying cause of your AFib.  Here are the possible treatments:
  • Treating the underlying cause – If your AFib is caused by an underlying, treatable issue, then treating that underlying problem can be the key to treating AFib.  For instance, treating an overactive thyroid, or stopping heavy alcohol use, might make AFib go away completely.
  • Resetting your heart’s rhythm – Your doctor may be able to reset the rhythm of your heart using a procedure called cardioversion.  Cardioversion can be done in two ways…
    • Electrical cardioversion uses a special type of electrical shock to reset the rhythm.  You should not feel the shock because you would be given a sedative beforehand.  You may also be given medication to help keep your heart in a normal rhythm after the procedure.
    • Medical cardioversion uses medications to restore the normal rhythm.  These medications may be given through an IV or taken by mouth.  It is often done in the hospital with continuous monitoring of your heart.  If the medication returns your heart to a normal rhythm, you may be prescribed the same medication to take at home.
  • Controlling the heart rate – If other treatments do not restore your normal rhythm, we can improve the symptoms and decrease complications by keeping the heart rate in the normal range.  This is done with medications, such as beta blockers or calcium channel blockers.
  • Special procedures – If other treatments have not worked, your doctor may recommend a procedure to destroy the area of heart tissue that is causing the chaotic electrical signals.  There are several different procedures; the one recommended depends on your specific situation.
  • Preventing Blood Clots – If you are at high risk for blood clots due to AFib, your doctor will prescribe a blood thinning medication called an anticoagulant.  There are several anticoagulant medications available now.  Your doctor will discuss the risks and benefits of these medications with you, then you and your doctor can determine which one is best for you.
If you have any questions about atrial fibrillation, please log into your account and send
us your question. We are here to help.

Dr. Anita Bennett MD – Health Tip Content Editor

Pin It on Pinterest

Share This
  • Sign in to your account

    Forgot screen name or password?


    First time user?
    Register your account now.

    Register Now

    Need Assistance?
    Contact us at 1-866-525-3362