Atrial Fibrillation/Heart Flutter

With a normal heart rhythm, the atria (upper chambers) and ventricles (lower chambers) work as a team, contracting and relaxing to move blood to the lungs and into the body.
 
AFib is a condition in which the electrical impulses of the heart lose their regular pattern. The heart rhythm (pattern of heart beat) becomes erratic, and often the heart beats too fast. This irregularity means that the heart does not pump a normal amount of blood out of the atrium, causing the blood that is left behind to pool and form clots. Untreated atrial fibrillation can lead to a heart failure and increases the risk of stroke.



So what is the good news?   AFib can be controlled. With medical guidance, you can lead a normal, active life. Through new procedures, medications and technologies, AFib is easier to manage than ever before. 
 
Symptoms of AFib:
  • Racing, irregular heartbeat
  • Flopping sensation in the chest
  • Shortness of breath
  • Weakness, dizziness or fainting
  • Chest discomfort or pain, especially when the heart is beating fast.
 
Were you surprised you were diagnosed with AFib? Some people never feel any symptoms. Even if you do not experience symptoms, it is important to understand your condition. 
 
Goals for treating AFib:
  • Prevent blood clots to reduce stroke risk
  • Restore normal heart rhythm
  • Control heart rate-allow the heart to beat at a normal rate to prevent heart failure
  • Uncover underlying causes (thyroid disease, electrolyte imbalances or blocked heart arteries)
  • Treat adjustable risk factors-sleep apnea, hypertension, weight management, stimulant consumption (eliminate or limit caffeine and alcohol)

Treatments for Atrial Fibrillation/Heart Flutter

With the state-of-the-art equipment and technology at the Meijer Heart Center, you are in the best place to access the latest treatments for atrial fibrillation. What truly sets us apart is the way we care for you. Spectrum Health electrophysiologists not only work together to come up with the best care plans for our patients, but also to deliver the best patient experience possible.

For example, when we implant pacemakers, we safely and effectively let patients go home the same day, rather than spending a night in the hospital. The next day, the patient's device is checked remotely via the Internet. This keeps costs down, has proven to be just as safe, and it makes patients happier to be home in the comfort of their own beds. No other comparable EP program in the nation is able to do this like Spectrum Health.

Ablation Procedures
This procedure guides a wire into your heart to destroy small areas of heart tissue that may be causing your abnormal heartbeat. Heat (radiofrequency) or cold energy (cryoablation) are the two most common ways to destroy abnormal heart tissue. It's an alternative to long-term or lifelong medication therapy.

Cardiac Rhythm Monitoring
With consistent check-ins and some assisted mechanical devices we can keep an eye on your heart rhythm, helping to understand and diagnose certain heart disease.

Catheter-Based Mapping
This is a minimally invasive procedure that identifies the location of heart rhythm abnormalities in the heart so treatments like ablation can be more effective.

Implantable Cardioverter Defibrillator
This device combines the steady regulation of a pacemaker with the ability to shock the heart back into rhythm. It is used to treat congestive heart failure as well as arrhythmia, which can lead to sudden cardiac arrest.

Left Atrial Appendage Occlusion
This procedure attempts to reduce the risk of  blood clots from entering the bloodstream, potentially preventing a stroke in patients with atrial fibrillation.

Medication Management
Along with very important lifestyle changes, there are a variety of medicines used to help treat heart conditions. Medicines for heart disease are used to ease discomfort or lessen symptoms, but some can also be essential in preventing life-threatening episodes. It is important to take your medicines exactly as prescribed, and work with your doctor on both lifestyle and medicine changes.

Pacemaker
Your doctor may recommend a pacemaker to stimulate a faster heart rate when your heart beats too slow and the problem can't be fixed with other treatments.

Stereotaxis Navigation
A method of ablation that offers a more precise, and potentially more effective, delivery of the treatment.

Surgical MAZE
Surgical intervention (performed by our cardiothoracic surgeons)-typically referred to as a MAZE procedure- a treatment for AFib that creates a “maze” of new electrical pathways to let electrical impulses travel easily through the heart. This is usually performed in combination with valve or open-heart surgery

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What Is Atrial Fibrillation?

The speed and pattern of your heartbeat is called your heart rhythm and can be felt by feeling the pulse. Your heart rhythm is set by signals from the heart’s electrical system. If the signal is jumbled or irregular it can cause the upper chambers (atria) of your heart to tremble rapidly. An abnormal heart rhythm is called an arrhythmia. Atrial fibrillation is one type of abnormal rhythm. The muscle looks as if it is wiggling instead of squeezing (contracting).

What Happens During Atrial Fibrillation?

The human heart has four chambers. The upper ones are called atria; the lower ones, ventricles. All chambers must squeeze in a certain way to move the blood properly. Your heart’s electrical system involves specialized cells that tell the heart when to beat. If these cells malfunction and send extra electrical signals, the atria beat very quickly and uneven. A fibrillating atrium, however, has small, irregular, fast contractions. All the blood inside the atria is not pumped into ventricles, so blood pools. Pooled blood may clot, and clots can be pushed into the bloodstream and cause strokes. Ventricles work harder to get blood to the body, and heart failure may result.

What Causes Atrial Fibrillation?

Among the many causes, the most common is aging. Others are heart problems such as hypertension (high blood pressure), congestive heart failure (CHF), and mitral valve disease (mitral stenosis). Lung diseases, other illnesses (e.g., diabetes), and overactive thyroid increase the risk of developing atrial fibrillation. Caffeine, nicotine (cigarettes), and too much alcohol can cause it or make it worse.

What Are the Symptoms of Atrial Fibrillation?

Many people have atrial fibrillation and never feel it.

Symptoms often include the feeling of irregular or too fast (palpitations) heartbeats. Diffisculty breathing, chest pain, or fainting may occur. Some people feel tired or cannot exercise.

Chest pain or signs of stroke must be checked immediately.

How Is Atrial Fibrillation Diagnosed?

The health care provider looks for a certain pattern on an electrocardiogram (ECG), which shows the heart’s electrical activity.

The health care provider may check movements of the atria with an echocardiogram (using ultrasound to examine the heart and capture the moving images on a video). If your atrial fibrillation comes and goes, your health care provider may order a portable recorder of your heart rhythm (Holter monitor).

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How Is Atrial Fibrillation Treated?

Treatment focuses on the cause. For example, if the person has thyroid disease, that illness is treated. If the cause is too much caffeine or excess alcohol, less should be used.

Controlling heart rhythm and the fibrillation rate with drugs is important. These medications are known as antiarrhythmics and are used to slow down the heart rate and make it regular. Sometimes atrial fibrillation stops on its own.

Clots are one complication of fibrillation. Blood thinners (anticoagulants) such as warfarin (e.g., Coumadin®) may be given for clots or to prevent them. This drug causes easy bruising or bleeding, so drug levels are checked regularly. Newer blood thinners such as dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis) do not require periodic blood tests to monitor their levels.

The abnormal rhythm can sometimes be shocked back to normal (called cardioversion). During this procedure, a heart specialist (cardiologist) will give your heart a brief electric shock in attempting to briefly stop all electrical activity, hoping that the normal heart rhythm will take over. Chest pain, low blood pressure, CHF, or other serious symptoms may require emergency cardioversion. A dual-chamber pacemaker may be placed. A heart catheter or surgery (maze procedure) may be used to destroy the part of the heart causing fibrillation.

DOs and DON’Ts in Managing Atrial Fibrillation:
  • DO eat a heart-healthy diet (less fat and cholesterol).
  • DO keep to an ideal body weight.
  • DO reduce stress.
  • DO exercise as much as you can if you are taking the proper drugs and have no symptoms.
  • DO take your medicines as prescribed. Have blood drug levels checked.
  • DO call your health care provider if you have drug side effects or if you have new or worsening symptoms (dizziness, chest pain or tightness, fainting, shortness of breath).
  • DON’T do activities that cause bruising if you are taking a blood thinner.
  • DON’T use tobacco.
  • DON’T drink too much alcohol or caffeine.
FOR MORE INFORMATION

Contact the following source:

  • American Heart Association
    Tel: (800) 242-8721
    Website: http://www.americanheart.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor