Atrial fibrillation (patient information): Difference between revisions
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'''Editor-in-Chief:''' Prashant Sharma | '''Editor-in-Chief:''' Prashant Sharma | ||
'''For the WikiDoc page for this topic, click [[Atrial fibrillation|here]]''' | |||
==What is | ==What is atrial fibrillation?== | ||
Atrial fibrillation/flutter is a heart rhythm disorder (arrhythmia). It usually involves a rapid [[heart rate]], in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner. | Atrial fibrillation/flutter is a heart rhythm disorder ([[arrhythmia]]). It usually involves a rapid [[heart rate]], in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner. | ||
==What are the symptoms of | ==What are the symptoms of atrial fibrillation?== | ||
You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time. | You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time. | ||
Symptoms may include: | Symptoms may include: | ||
*Pulse that feels rapid, racing, pounding, fluttering, or too slow | *Pulse that feels rapid, racing, pounding, fluttering, or too slow | ||
*Pulse that feels regular or irregular | *Pulse that feels regular or irregular | ||
*Sensation of feeling the heart beat (palpitations) | *Sensation of feeling the heart beat ([[palpitations]]) | ||
*Shortness of breath while lying down | *Shortness of breath while lying down | ||
*Confusion | *Confusion | ||
*Dizziness, light-headedness | *Dizziness, light-headedness | ||
*Fainting | *Fainting ([[syncope]]) | ||
*Fatigue | *[[Fatigue]] | ||
Note: Symptoms may begin or stop suddenly. | Note: Symptoms may begin or stop suddenly. | ||
==What causes | ==What causes atrial fibrillation?== | ||
[[Arrhythmias]] are caused by a disruption of the normal electrical [[conduction system]] of the heart. | [[Arrhythmias]] are caused by a disruption of the normal electrical [[conduction system]] of the heart. | ||
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The signal leaves the [[SA node]] and travels through the two upper chambers ([[atria]]). Then the signal passes through another node (the [[AV node]]), and finally, through the lower chambers ([[ventricles]]). This path enables the chambers to contract in a coordinated fashion. | The signal leaves the [[SA node]] and travels through the two upper chambers ([[atria]]). Then the signal passes through another node (the [[AV node]]), and finally, through the lower chambers ([[ventricles]]). This path enables the chambers to contract in a coordinated fashion. | ||
In [[atrial fibrillation]], the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse. | In [[atrial fibrillation]], the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse. In [[atrial flutter]], the ventricles may beat very fast, but in a regular pattern. If the [[atrial fibrillation]]/[[flutter]] is part of a condition called [[sick sinus syndrome]], the sinus node may not work properly. The heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body. | ||
In [[atrial flutter]], the ventricles may beat very fast, but in a regular pattern. | |||
If the [[atrial fibrillation]]/[[flutter]] is part of a condition called [[sick sinus syndrome]], the sinus node may not work properly. The heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body. | |||
[[Atrial fibrillation]] can affect both men and women. It becomes more common with increasing age. | [[Atrial fibrillation]] can affect both men and women. It becomes more common with increasing age. | ||
Causes of [[atrial fibrillation]] include: | Causes of [[atrial fibrillation]] include: | ||
*Alcohol use (especially binge drinking) | *Alcohol use (especially binge drinking) | ||
*[[Congestive heart failure]] | *[[Congestive heart failure]] | ||
*[[Coronary artery disease]] (especially after a heart attack or [[coronary artery bypass surgery]]) | *[[Coronary artery disease]] (especially after a heart attack or [[coronary artery bypass surgery]]) | ||
*Heart surgery | *Heart surgery | ||
*High blood pressure (hypertension) | *High blood pressure ([[hypertension]]) | ||
*[[Hypertrophic cardiomyopathy]] | *[[Hypertrophic cardiomyopathy]] | ||
*Medications | *Medications | ||
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*[[Pericarditis]] | *[[Pericarditis]] | ||
*[[Valvular heart disease]] (especially [[mitral stenosis]] and [[mitral regurgitation]]) | *[[Valvular heart disease]] (especially [[mitral stenosis]] and [[mitral regurgitation]]) | ||
==When to seek urgent medical care== | ==When to seek urgent medical care== | ||
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An [[ECG]] shows [[atrial fibrillation]] or [[atrial flutter]]. Continuous ambulatory cardiac monitoring -- [[Holter monitor]] (24 hour test) -- may be necessary because the condition often occurs at some times but not others (sporadic). | An [[ECG]] shows [[atrial fibrillation]] or [[atrial flutter]]. Continuous ambulatory cardiac monitoring -- [[Holter monitor]] (24 hour test) -- may be necessary because the condition often occurs at some times but not others (sporadic). | ||
====Diagnostic Testing==== | |||
Tests to find underlying heart diseases may include: | Tests to find underlying heart diseases may include: | ||
*[[Coronary angiography]] | *[[Coronary angiography]] | ||
*[[Echocardiogram]] | *[[Echocardiogram]] | ||
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*[[Nuclear imaging tests]] | *[[Nuclear imaging tests]] | ||
====Treatment strategies==== | |||
Basic treatment strategies involve the following: | Basic treatment strategies involve the following: | ||
In certain cases, [[atrial fibrillation]] may need emergency treatment to to get the heart back into normal rhythm. This treatment may involve [[electrical cardioversion]] or intravenous (IV) drugs such as [[dofetilide]], [[amiodarone]], or [[ibutilide]]. Drugs are typically needed to keep the pulse from being too fast. | In certain cases, [[atrial fibrillation]] may need emergency treatment to to get the heart back into normal rhythm. This treatment may involve [[electrical cardioversion]] or intravenous (IV) drugs such as [[dofetilide]], [[amiodarone]], or [[ibutilide]]. Drugs are typically needed to keep the pulse from being too fast. | ||
Long-term treatment varies depending on the cause of the [[atrial fibrillation]] or [[flutter]]. Medications to slow the heartbeat may include: | Long-term treatment varies depending on the cause of the [[atrial fibrillation]] or [[flutter]]. Medications to slow the heartbeat may include: | ||
*[[Beta-blockers]] | *[[Beta-blockers]] | ||
*[[Calcium channel blockers]] | *[[Calcium channel blockers]] | ||
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For some patients with [[atrial flutter]], [[radiofrequency ablation]] can cure the [[arrhythmia]] and is the treatment of choice. Some patients with [[atrial fibrillation]] and a rapid heart rate may need the [[radiofrequency ablation]] done directly on the [[AV junction]] (the area that normally filters the impulses coming from the [[atria]] before they move on to the [[ventricles]]). | For some patients with [[atrial flutter]], [[radiofrequency ablation]] can cure the [[arrhythmia]] and is the treatment of choice. Some patients with [[atrial fibrillation]] and a rapid heart rate may need the [[radiofrequency ablation]] done directly on the [[AV junction]] (the area that normally filters the impulses coming from the [[atria]] before they move on to the [[ventricles]]). | ||
Ablation of the AV junction | Ablation, a procedure that disconnect the electrical pathway between the upper chambers (atria) and the lower chambers [[ventricles]] of the heart, in the AV junction can complicate into a complete heart block. This condition needs to be treated with a [[permanent pacemaker]]. | ||
==Where to find medical care for | ==Where to find medical care for atrial fibrillation== | ||
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Atrial fibrillation}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Atrial fibrillation] | [http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Atrial fibrillation}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Atrial fibrillation] | ||
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==Possible complications== | ==Possible complications== | ||
*Fainting (syncope), if [[atrial fibrillation]] and [[atrial flutter]] cause the pulse to be too quick or slow. | *Fainting ([[syncope]]), if [[atrial fibrillation]] and [[atrial flutter]] cause the pulse to be too quick or slow. | ||
*Heart failure | *[[Heart failure]] | ||
*[[Stroke]], if clots break off and travel to the brain (drugs that thin the blood such as [[heparin]] and [[warfarin]] can reduce the risk). | *[[Stroke]], if clots break off and travel to the brain (drugs that thin the blood such as [[heparin]] and [[warfarin]] can reduce the risk). | ||
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http://www.nlm.nih.gov/medlineplus/ency/article/000184.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000184.htm | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Patient Information]] | [[Category:Patient Information]] | ||
Revision as of 12:25, 29 June 2011
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Atrial Fibrillation Microchapters | |
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Diagnosis | |
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Treatment | |
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Cardioversion | |
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Anticoagulation | |
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Surgery | |
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Case Studies | |
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Atrial fibrillation (patient information) On the Web | |
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Directions to Hospitals Treating Atrial fibrillation (patient information) | |
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Risk calculators and risk factors for Atrial fibrillation (patient information) | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Editor-in-Chief: Prashant Sharma
For the WikiDoc page for this topic, click here
What is atrial fibrillation?
Atrial fibrillation/flutter is a heart rhythm disorder (arrhythmia). It usually involves a rapid heart rate, in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner.
What are the symptoms of atrial fibrillation?
You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time.
Symptoms may include:
- Pulse that feels rapid, racing, pounding, fluttering, or too slow
- Pulse that feels regular or irregular
- Sensation of feeling the heart beat (palpitations)
- Shortness of breath while lying down
- Confusion
- Dizziness, light-headedness
- Fainting (syncope)
- Fatigue
Note: Symptoms may begin or stop suddenly.
What causes atrial fibrillation?
Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart.
Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated way. The electrial impulse that signals your heart to contract in a synchronized way begins in the sinoatrial node (SA node). This node is your heart's natural pacemaker.
The signal leaves the SA node and travels through the two upper chambers (atria). Then the signal passes through another node (the AV node), and finally, through the lower chambers (ventricles). This path enables the chambers to contract in a coordinated fashion.
In atrial fibrillation, the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse. In atrial flutter, the ventricles may beat very fast, but in a regular pattern. If the atrial fibrillation/flutter is part of a condition called sick sinus syndrome, the sinus node may not work properly. The heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body.
Atrial fibrillation can affect both men and women. It becomes more common with increasing age.
Causes of atrial fibrillation include:
- Alcohol use (especially binge drinking)
- Congestive heart failure
- Coronary artery disease (especially after a heart attack or coronary artery bypass surgery)
- Heart surgery
- High blood pressure (hypertension)
- Hypertrophic cardiomyopathy
- Medications
- Overactive thyroid gland (hyperthyroidism)
- Pericarditis
- Valvular heart disease (especially mitral stenosis and mitral regurgitation)
When to seek urgent medical care
Call your health care provider if you have symptoms of atrial fibrillation or flutter.
Treatment options
The health care provider may may perform the following tests for this condition: An ECG shows atrial fibrillation or atrial flutter. Continuous ambulatory cardiac monitoring -- Holter monitor (24 hour test) -- may be necessary because the condition often occurs at some times but not others (sporadic).
Diagnostic Testing
Tests to find underlying heart diseases may include:
- Coronary angiography
- Echocardiogram
- Electrophysiologic study (EPS)
- Exercise treadmill ECG or Stress test
- Nuclear imaging tests
Treatment strategies
Basic treatment strategies involve the following: In certain cases, atrial fibrillation may need emergency treatment to to get the heart back into normal rhythm. This treatment may involve electrical cardioversion or intravenous (IV) drugs such as dofetilide, amiodarone, or ibutilide. Drugs are typically needed to keep the pulse from being too fast.
Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medications to slow the heartbeat may include:
- Beta-blockers
- Calcium channel blockers
- Digitalis
- Anti-arrhythmic drugs may be used to get the heart back into a normal rhythm. These medications may work well in many people, but they can have serious side effects. Many patients may go back to atrial fibrillation even while taking these medications.
Blood thinners, such as heparin and warfarin (Coumadin) reduce the risk of a blood clot traveling in the body (such as a stroke). Because these drugs increase the chance of bleeding, not everyone will use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your doctor will consider your age and other medical problems to decide which drug is best.
Some patients with atrial fibrillation, rapid heart rates, and intolerance to medication may need a catheter procedure on the atria called radiofrequency ablation.
For some patients with atrial flutter, radiofrequency ablation can cure the arrhythmia and is the treatment of choice. Some patients with atrial fibrillation and a rapid heart rate may need the radiofrequency ablation done directly on the AV junction (the area that normally filters the impulses coming from the atria before they move on to the ventricles).
Ablation, a procedure that disconnect the electrical pathway between the upper chambers (atria) and the lower chambers ventricles of the heart, in the AV junction can complicate into a complete heart block. This condition needs to be treated with a permanent pacemaker.
Where to find medical care for atrial fibrillation
Directions to Hospitals Treating Atrial fibrillation
What to expect (Outlook/Prognosis)
The disorder is usually controllable with treatment. Many people with atrial fibrillation do very well.
Atrial fibrillation tends to become a chronic condition, however. It may come back even wtih treatment.
Possible complications
- Fainting (syncope), if atrial fibrillation and atrial flutter cause the pulse to be too quick or slow.
- Heart failure
- Stroke, if clots break off and travel to the brain (drugs that thin the blood such as heparin and warfarin can reduce the risk).