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Atrial Fibrillation: Treatments to get back on beat

February 2016 


If you’ve had an exciting, nerve-wracking event, such as a promising Valentine’s Day date or giving a speech in public, then you’ve probably experienced the feeling of having "butterflies" in the stomach. But have you ever experienced the feeling of a butterfly or fish flopping in your chest? This is how a person with atrial fibrillation, or AFib for short, commonly describes what it feels like to have the condition.

What is atrial fibrillation?

AFib is a type of heart arrhythmia. An arrhythmia is any condition in which the heart does not beat in its normal, regular rhythm. It might beat too fast, too slow or irregularly. With AFib, the heart beats irregularly. This causes the palpitations, or the flopping fish feeling. The most common causes of AFib are coronary artery disease, high blood pressure, heart failure and problems with heart valves.

What are the symptoms?

"Heart palpitations are a classic symptom of AFib," says Dr. Nazem Akoum, UW associate professor of medicine and director of the atrial fibrillation program at the UW Medicine Regional Heart Center. "It happens when the electrical signals within the heart become disorganized. If you feel your pulse while this is happening, it may feel like an offbeat drummer."

Other symptoms include:

  • Shortness of breath
  • Chest pain
  • Dizziness or fainting

Some AFib symptoms are more subtle, such as increased fatigue or not being able to exercise as you normally would. Some people may not have any symptoms at all. In some cases, AFib can lead to heart failure, but the most serious consequence of AFib is stroke. This occurs because small blood clots can form within the heart during atrial fibrillation. These clots can break free, travel to the brain, block blood flow and cause a stroke. Even if you have no symptoms, the risk of stroke is still there warns Akoum.

Act FAST for Stroke

The National Stroke Association recommends using F.A.S.T. as an easy way to remember and identify the most common symptoms of a stroke.

FACE: Ask the person to smile. Does one side of the face droop?
ARMS: Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
TIME: If you observe any of these signs, call 9-1-1 immediately.

Recognizing stroke and calling 9-1-1 will quickly improve outcomes for stroke patients. Also note the time of the first symptom. This information is important and can affect treatment decisions.

While experiencing an episode of atrial fibrillation is not necessarily a medical emergency, the consequences of AFib (stroke and heart failure) are. "Stroke is the most devastating thing that could come of having this arrhythmia," says Akoum. "The risk is there no matter what your symptoms are and it varies from patient to patient. Therefore, it is important to talk to your doctor about treatment options."

What are the treatment options?

In general, treatment options include heart healthy lifestyle changes, medicines to control heart rhythm and reduce stroke risk, and medical procedures. A treatment plan is determined by how often a patient experiences AFib and the severity of symptoms, so it is very individualized. If medications don’t work to control the condition, a catheter ablation procedure is an effective option. It is a minimally invasive procedure, and most patients only need to stay one night in the hospital for observation and are on their feet the same day.

"During the three-hour procedure, we access the heart through veins in the groin area and neck, using catheters," explains Akoum. "Then we try to find the electrical short circuits in the heart that are causing the arrhythmia and eliminate them."

Even with these effective treatments, making heart-healthy lifestyle choices not only helps you keep a handle on AFib, but also benefits your overall wellness. You can do this by following a heart-healthy diet low in saturated fat, not smoking, engaging in physical activity and maintaining a healthy weight.

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