To Your Health: Don’t ignore racing heart beat
By Dr. Manoj Duggal September 4, 2012 2:28PM
Dr. Manoj Duggal
Updated: October 6, 2012 1:46PM
Atrial fibrillation is a relatively common rhythm disorder that results in the upper chambers of the heart beating rapidly in an uncontrolled manner.
The human heart has two upper chambers called atrium and two bottom chambers called ventricles which beat in a synchronized fashion.
The heart rate varies between 60 and 100 beats per minute and the body’s biological pacemaker is capable of increasing the heart beat with exercise. In atrial fibrillation, the upper chambers of the heart beat much faster (at rates between 300 and 600 beats per minute) than the rest of the heart. The atrium quivers instead of beating normally and loses synch with the bottom chambers.
Patients often can feel their heart beating faster than normal and irregularly. Others may have symptoms of light-headedness (fainting), tiredness, shortness of breath, lack of energy and some have frequent urination. However, some patients may have very minimal or slight symptoms.
Currently, in the United States, about five million people have A-Fib. According to estimates, up to 12 million people will suffer from it by 2050. People older than 40 have a one in four lifetime risk of developing A-Fib. It is the most common arrhythmia and contributes to 80,000 deaths annually.
A-Fib can result in incomplete emptying of blood resulting in blood pooling and formation of blood clots in the atrium. These blood clots can result in a stroke.
Up to 30 percent of patients seen in the emergency room with a new stroke are related to A-Fib.
Ultimately, A-Fib can cause weakening of the heart muscle and result in congestive heart failure.
Frequent episodes can lead to anxiety and emotional distress. The constant fear of episodes can result in depression in some patients. It is a progressive disease and frequent episodes result in electrical changes, scarring and enlarging of the atrium.
Early interventions may help halt the progression and even cure atrial fibrillation.
A number of factors can contribute to the development of A-Fib: heart valve disease, hypertension, coronary artery disease and congestive heart failure. Heavy alcohol intake, obesity, sleep apnea, stimulants, over-active thyroid gland and lung diseases can contribute to the development of this rhythm disturbance as well. Prevalence increases with age.
AFib is diagnosed by an electrocardiogram (EKG) and if it occurs episodically a portable EKG monitor helps make a diagnosis. Stress test, echo cardiogram and various blood tests will help find the potential cause.
Treatment varies with the type of atrial fibrillation and the symptoms of the patient. Medications can be used to reduce symptoms and frequency of episodes. Blood thinners are used to reduce risk of stroke.
Many different strategies are used to reduce frequency and even cure atrial fibrillation. Medications called antiarrhythmic agents are used to prevent or reduce the frequency of episodes and a catheter ablation can cure the disease.
There are ways to reduce progression of A-Fib and prevent complications associated with it.
After a patient is diagnosed with the condition, the ideal goals include managing risk factors for stroke, preventing blood clots, restoring the heart to a normal rhythm, reducing the heart rate and preventing heart failure.
Medications, including Warfarin, are used to reduce the risk of strokes. A procedure known as ablation, in which long catheters are inserted into the femoral vein and advanced into the heart, destroys cells which cause triggers for atrial fibrillation. Imaging techniques are used to position the ablation catheters. Three dimensional mapping of the heart improves the success of ablation and reduces the risks associated with the procedure.
Robotic catheter navigation also can be used to maneuver ablation catheters precisely to areas of the heart which trigger atrial fibrillation. Energy sources such as radio frequency or cryo energy eliminate these trigger points.
Atrial fibrillation is the most common rhythm disorder, which may result in stroke or other cardiac complications. Stroke reduction is the first goal of treatment and this can be achieved by usage of various blood thinners. In patients with symptomatic atrial fibrillation, a regular rhythm can be achieved by medications or a catheter ablation.
Dr. Duggal is a cardiac electrophysiologist with Advocate Christ Medical Center.