Treating Atrial Fibrillation

By Dr. Richard Vest
Electrophysiologist at Birmingham Heart Clinic

What is atrial fibrillation?

Atrial fibrillation (AF) is the most common type of arrhythmia or irregular heartbeat. AF occurs if rapid, disorganized electrical signals cause the heart’s two upper chambers—called the atria—to contract very fast and irregularly. As a result, the heart’s upper and lower chambers don’t work together as they should. When atria do not contract effectively, the blood may pool and/or clot. If a blood clot becomes lodged in an artery in the brain, a stroke may occur.

What are the risk factors?

Age, history of heart disease, high blood pressure, obesity, and other chronic conditions are all risk factors of atrial fibrillation.

What are the symptoms?

People with AF may not feel any symptoms. However, even when AF isn’t noticed, it can increase the risk of stroke. In some people, AF can cause chest pain or heart failure, especially if the heart rhythm is very rapid.

Other symptoms may include heart palpitations, fatigue, lightheadedness, dizziness, shortness of breath, and confusion.

If you have any symptoms of atrial fibrillation, make an appointment with your cardiologist. An electrocardiogram or holter monitor may be ordered to determine if your symptoms are related to atrial fibrillation or another heart rhythm disorder.

What tests are used to diagnose atrial fibrillation?

The electrical activity of the heart is measured by an electrocardiogram (ECG or EKG). By placing electrodes at specific locations on the body (chest, arms, and legs), a graphic representation, or tracing, of the electrical activity can be obtained. Changes in an ECG from the normal tracing can indicate arrhythmias, as well as other heart-related conditions.

Another option to diagnose AF is to use a holter monitor. This portable ECG device is carried in a patient’s pocket or worn on a belt or shoulder strap. It records your heart’s activity for 24 hours or longer, which provides your doctor with a prolonged look at your heart rhythms.

How to treat atrial fibrillation?

Generally, the treatment goals for atrial fibrillation are to reset the rhythm or control the heart rate and prevent blood clots. For most patients with atrial fibrillation, slowing the heart rate with medication is the most appropriate treatment to regain normal heart rhythm. Electrical cardioversion can also be used.