Atrial fibrillation (AF) is the most common type of arrhythmia; it affects over 1% of the population.
When the heart is in atrial fibrillation, the electrical impulses in the two upper chambers of the heart (atria) are conducted very quickly (up to 400 impulses per minute) and irregularly. In response, the lower chambers of the heart (ventricles) also contract irregularly between 80 and 180 times per minute. This irregular heart rate, especially a fast rate, can prevent the heart from doing its job and makes it more difficult for blood to be transported to the other organs.
In the case of atrial fibrillation, the atria no longer contract efficiently; blood stays in these chambers for a longer period of time, and clots can form in these cavities and may enter the bloodstream. If a clot travels to a brain artery, this can result in stroke.
The most frequent causes of atrial fibrillation are:
It is not always possible to find a specific cause of arrhythmia; these cases are referred to as isolated atrial fibrillation. No matter what the cause of atrial fibrillation, the risk of developing this type of arrhythmia increases with age.
Each patient experiences atrial fibrillation in a different way. Some people do not experience any symptoms, while others have very pronounced symptoms from the onset of episodes. The most frequent symptom is chest palpitations. Palpitations feel like fast and/or irregular heartbeats, a flutter or chest pain.
During an atrial fibrillation episode, patients may also experience:
In some cases, atrial fibrillation is discovered accidentally during a routine exam. When palpitations are frequent, of long duration, or associated with other debilitating symptoms, the doctor will prescribe tests that will confirm the presence of atrial fibrillation and determine its cause.
Atrial fibrillation treatment includes two components: treating the arrhythmia itself and preventing the formation of clots in the atria.
There are two goals when treating atrial fibrillation with drug therapy:
To re-establish sinus rhythm, medication can be administered (generally intravenously), or electrical cardioversion will be applied. Electrical cardioversion involves putting the patient under anesthesia with an intravenous medication and then administering an electric current directly to the patient's chest. No matter what method is used to re-establish sinus rhythm, long-term medication is usually prescribed to decrease atrial fibrillation recurrence.
Long-term medication is prescribed in this case; this therapy generally makes symptoms subside and allows patients to return to their normal activities.
The choice of treatment (control of rhythm versus control of rate) depends on a number of factors, including the patient’s age, duration of the atrial fibrillation, number of previous episodes, cause of the atrial fibrillation, medication administered in the past, etc. and current symptoms associated to atrial fibrillation.
It is important to advise your treating doctor of medication side effects or persistent symptoms. You may need to try more than one medication before the best choice is found for your particular case.
In specific situations, the doctor will conduct an ablation (hyperlink?) by removing the tissue responsible for the atrial fibrillation from the atria. During this procedure, catheters are inserted into the heart to locate the diseased areas, which are then removed either by electrical energy or the application of intense cold.
To determine whether a blood thinner is necessary and to establish the most appropriate medication and its length of administration, the doctor will consider a number of factors, including the patient's age and sex, the cause of the atrial fibrillation, any related diseases (e.g., hypertension, diabetes) as well as the risk of bleeding.
For people with atrial fibrillation, certain daily habits can promote the onset of new arrhythmia episodes, such as drinking alcoholic beverages. People with this disease must also be careful when they take over-the-counter medications, which may contain stimulants that trigger atrial fibrillation or that interact with the medication prescribed to treat their condition. Consult your pharmacist before taking over-the-counter medications to help you avoid this problem.