Atrial fibrillation

  • Atrial fibrillation (AF) (Atria + fibrillation) is the most common cardiac arrhythmia.
  • Chaotic electric activity in the atria of the heart mean that they no longer contract, while the ventricles contract irregularly.
  • AF can come and go (paroxysmal) or it can become the main heart rhythm (persistent).
  • Doctors call fibrillation permanent when they and the patient have decided to stop doing things in an effort to reverse it.
  • AF not only causes discomfort in patients, but puts them at risk of stroke, heart failure and dementia.
  • Treatment of AF is split in three categories: rhythm control, rate control and complication avoidance.
  • ECGs and holter monitors are used to diagnose the arrhythmia.
  • Rhythm control refers to any treatment that tries to reverse AF and restore sinus rhythm.
  • Rate control aims to reduce the rate at which the ventricles contract, thus reducing patient discomfort and improving cardiac function.
  • AF causes stroke and dementia because small blood clots that form in the stagnant atria are catapulted to the brain. In an effort to protect patients from complications of AF, doctors stop clot formation by prescribing blood thinners.
  • AF can also be treated with more “physical” methods. Rhythm control (see above) can also be achieved by shocking the heart (under patient sedation), which restores atria synchronization. Catheter ablation is an invasive method that destroys the areas of the atria responsible for the arrhythmia.

 

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