Heart and Vascular Care
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Terry was working in her yard one day when she noticed she felt a little weak and dizzy. She is 62, in fairly good health, but it was a warm day, so she just sat down to rest and assumed she’d overdone it a bit.
A few days later, she was folding laundry and felt the same sensation, only this time she could tell her heart was acting strangely – it felt like a fish was flopping around in her chest. She was light-headed and very tired. Something was wrong, and this time the hot sun couldn’t be the culprit.
Terry’s daughter decided she should get this checked out. She took Terry to the emergency room, where they learned she had a type of irregular heartbeat called atrial fibrillation (AFib).
What AFib is
A regular heartbeat has a steady frequency, a consistent time between each beat. It is smooth and rhythmic, increasing and decreasing with the demand for blood, based on the level of physical activity.
During atrial fibrillation, the heartbeat is irregular; in this case, it is no longer beating evenly. It is out of sync.
This means the flow of blood is sluggish and moving slower in the top chambers of the heart (atria). This slowly moving blood can potentially create clots inside the heart chamber. If a clot forms and travels to the brain blood vessels, it could block vital blood flow to the brain, which could result in a stroke.
The Centers for Disease Control and Prevention estimates that up to 12 million people in the United States will have atrial fibrillation by 2030.
What AFib feels like
AFib can affect everyday activity in a number of ways. In extreme cases, the patient feels tired and short of breath with everyday activity. They get winded quickly and fatigued from even the most basic daily chores. And there are many people who, like Terry, have atrial fibrillation and never even know it, attributing their symptoms to over-exertion or just being out of breath due to age or weight.
Many patients find out they have the condition after having a routine medical exam or while being treated for some other condition. “Less than 20% of people have no symptoms, and we diagnose the problem by luck,” explained Sameh Khouzam, MD, a cardiac electrophysiologist for Kettering Health. “Most people will feel something in their chest and don’t know what it means, so they go to the emergency room.”
What causes AFib
The causes of atrial fibrillation are widely debated, and it cannot be prevented entirely. Age is known to be a major factor in the development of the disorder. Sleep apnea, severe snoring, or breathing problems while sleeping all can trigger AFib. Someone with this condition should be checked for atrial fibrillation because treating one may help the other.
There are things people can do to reduce their risk. Maintaining a healthy weight and blood pressure can help, although there are instances where people with perfect blood pressure still have AFib. Limiting alcohol consumption also may be a factor in controlling the condition.
How AFib is treated
Once diagnosed, treatments for atrial fibrillation vary based on the situation, but the most typical treatments are medication or ablation.
“There are several different types of medication that can be used to treat AFib, but in general, those have about a 40% success rate of keeping people in a normal rhythm,” said Dr. Khouzam.
An ablation is accomplished in one of two ways: using radio frequency technology, or by freezing the affected tissue to effectively short it out and prevent the misfires from traveling to the rest of the heart. Both procedures involve going through the side of the groin, up to the left atrium of the heart.
Sometimes pulmonary veins (the blood vessels that drain blood from the lungs to the left atrium) have a misfire or “short circuit” around them which travels to the rest of the heart. In this case, the procedure will control the abnormal signals around these veins and create an electrical roadblock to prevent the heart from going out of normal rhythm.
Dr. Khouzam noted that ablation procedures have about a 70-80% success rate, but the sooner a patient sees a healthcare provider, the better. “If a patient has been in AFib for a long time, say for more than a year, the success rate of the procedure is greatly reduced.”