Atrial fibrillation, or Afib, is the most common type of abnormal heart rhythm and the leading cause of stroke in the United States.
In fact, Afib sufferers may be up to five times more likely to have a stroke. Afib causes a rapid and disorganized heartbeat that occurs in the upper chambers of the heart (the atria). During an Afib episode, the atria may beat between 350 and 600 times per minute, compared with the normal 50 to 100 beats per minute, making that segment of the heart appear to quiver or fibrillate.
Often, the exact cause of Afib is difficult to determine, but there are certain risk factors, including hypertension, diabetes, obesity, alcohol use, congestive heart failure, heart valve problems, thyroid disease and sleep apnea.
Common symptoms of the condition include fatigue, weakness, shortness of breath, palpitations, irregular heart beat, chest discomfort or dizziness
Some people with Afib have mild symptoms, with the condition being discovered during a routine physical exam or electrocardiogram.
Atrial fibrillation can occur in two main varieties. intermittent atrial fibrillation, often called “paroxysmal,” starts and stops on its own. “Persistent” atrial fibrillation is constant and typically only stops when interrupted by a medication or medical procedure (called a cardioversion).
Because Afib is so prevalent, particularly in those 60 and older, it is important to make every effort to prevent the condition. This includes a healthy lifestyle, maintaining normal body weight, as well as identifying and controlling conditions that put you at risk. Nevertheless, we see patients who develop atrial fibrillation despite leading a very healthy lifestyle.
As many as 2 percent of all Americans currently have Afib; 20 percent will experience it in their lifetime.
The likelihood of Afib increases steadily with age; about 6 percent of people are diagnosed with it by age 65.
Ten to 15 percent of patients in their 80s have Afib. This is important not just because it can lead to poor stamina and diminished quality of life, but also because it is a leading cause of stroke. It is estimated that up to 25 percent of all strokes may be due to Afib.
Treatment options have grown dramatically over the last decade.
Afib can be treated with pharmaceuticals, non-surgical and surgical procedures or a combination.
Patients’ risk of stroke must be evaluated so they can be treated with an appropriate blood thinner if they are at a high risk. There are also medications that can slow the heart rate or help keep the heart in normal rhythm.
The most common procedure used to treat Afib — called catheter ablation — involves threading a catheter through a vein in the leg up into the heart to cauterize and scar the abnormal tissue that causes the disease.
New technology allows for 3D mapping of the heart during catheter ablations, as well as reduced levels of radiation. Using GPS and ultrasound images, physicians can view the catheter ablation from inside the patient, so they can complete the procedure with more anatomical detail. Because physicians see a streaming image of the heart during the procedure, there is little need for traditional CT scans and other tests that expose patients to higher levels of radiation.
Anthony Magnano is a cardiac electrophysiologist with Diagnostic Cardiology Associates who practices at St. Vincent’s Medical Center. He is a member of the Duval County Medical Society.