Atrial Fibrillation (A-Fib)

Atrial Fibrillation (A-Fib)

Atrial Fibrillation, abbreviated as A-Fib, is a severe heart condition in which the heart goes through an irregular, chaotic and rapid heartbeat. An irregular rapid heartbeat is also known as “arrhythmia”. Atrial Fibrillation is dangerous and may be life-threatening, as it leads to blood clots in the heart, and then stroke, and heart failure. The resulting conditions of Atrial Fibrillation are life-threatening, otherwise, it itself is not fatal.

In a normal person, the upper part of the heart (atria) beats parallel to the lower chamber of the heart (ventricles). On the other hand, in Atrial Fibrillation, the beats of the Atria and the Ventricles are not simultaneous. The unmatching beats of the two portions of the heart are known as Atrial Fibrillation. It may not have symptoms in many patients, however, palpitations (fast & pounding heartbeat) and short breaths are very primary symptoms, a patient may experience.

Atrial Fibrillation may occur in continual episodes, as well as may continue with persistence. As it may result in blood clots, and heart failure, that is why it may be taken seriously.  It must be treated timely, so that the time factor may not aggravate the condition.

Symptoms of Atrial Fibrillation

There are several symptoms of A-Fib, which some people even don’t feel at all. However, more than half of the patients feel these symptoms.

1. The very first and most common symptom of A-Fib is that the patient feels a very fast, jerky, and pounding heartbeat. The pounding and fluttering heartbeat is also known as “palpitation”.
2. Extreme fatigue is another sign of A-Fib.
3. Dizziness and lightheadedness are also experienced by the patient.
4. Fainting or Syncope is also experienced by the patients. Fainting is a type of disorder in which you lose consciousness for a short time. It’s caused by a sudden drop in blood flow to the brain. A fainting episode usually lasts a few seconds or minutes, then the person wakes up and returns to normal.
5. The rapid heartbeat causes shortness of breath. The patient usually takes short breaths, like they are extremely tired. The shortness of breath is also known as Dyspnea.
6. Due to irregular heartbeat and blood flow, the patient goes through chest pain, which, in the medical field is known as “Angina“.
7. A perpetual weakness and tiredness prevail all the time, which reduces the ability to do exercise and physical work.

 

Causes of Atrial Fibrillation

The unusual heart structure is the main cause of Atrial Fibrillation. Other than the heart structure, some causes may be as follow;

• Coronary Artery Disease: Coronary artery disease (CAD) is a narrowing or blockage of your coronary arteries, usually due to plaque buildup.
• Heart attack: Medically known as a myocardial infarction, a heart attack means the blockage of the vessels, which transport blood and oxygen to the heart. The heart muscles die because of the lack of blood supply.
• Defective Heart:  A congenital heart defect.
• High blood pressure: High blood pressure is a common condition that affects the body’s arteries. It’s also called hypertension. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.
• Lung diseases: Diseases associated with the lungs also cause Atrial Fibrillation.
• Physical stress due to surgery, pneumonia, or other illnesses may be a cause of Atrial Fibrillation.

• Heart Surgery: Previous heart surgeries may cause A-Fib.
• Sick Sinus Syndrom: Problems with the heart’s natural pacemaker (sick sinus syndrome) may also cause A-Fib.
• Thyroid diseases:  An overactive thyroid (hyperthyroidism) and other metabolic imbalances affect heart rhythm.
• Use of stimulants: Stimulants including certain medications, caffeine, tobacco, and alcohol cause heartbeat problems.
• Sleep Apnea: It also causes A-Fib. Sleep Apnea is a serious sleep disorder, in which breathing, repeatedly stops and starts consecutively.
• Viral infections: Some viral infections especially influenza viruses affect the heartbeat and cause Atrial Fibrillation.
• Heart valve problems: 
  1. A heart valve may have a “Stenosis” or  “narrowed valve”, which does not allow a sufficient quantity of blood to or from the heart.
  2. A heart valve may have a “lose or leaking valve”, in which the valve flaps don’t close properly, causing blood to leak backward in your heart. This commonly occurs due to valve flaps bulging back, a condition called prolapse.
  3. In some cases, there is a solid sheet of tissues rather than valves, which blocks the flow of blood between the heart chambers.

Types of Atrial Fibrillation

Atrial fibrillation may be of the following types:

1. Paroxysmal Atrial Fibrillation. It is an occasional A-fib that has symptoms that come and go. These symptoms usually last for a few minutes to hours. Sometimes they last for a couple of days and weeks, with repeated episodes. Most people with Paroxysmal A-Fib may not need treatment, as it fades away on its own. But in the case of long-lasting Paroxysmal A-Fib, treatment is needed.
2. Persistent Atrial Fibrillation. As the indicates, it last for a longer period of time, and the heartbeat does not go back to normal on its own. If a person has A-fib symptoms, cardioversion or treatment with medications may be used to restore and maintain a normal heart rhythm.
3. Long-standing Persistent A-Fib. If the persistence of the condition lasts as long as 12 months, it is known as Long-Standing Persistent A-Fib. It needs serious care and treatment.
4. Permanent Atrial Fibrillation. It is not a restorable condition. The patient needs exclusive treatment to avoid blood clots.

Risk Factors of Atrial Fibrillation

• Age Factor:

  Advancing age increases the risk of Atrial Fibrillation. People older than 65 have higher chances of A-Fib. It is uncommon in boys and children, however, those who are suffering from Obesity may have the risk.

• High Blood Pressure:

  Patients with high blood pressure are vulnerable to A-Fib. Having high blood pressure, especially if it’s not well controlled with lifestyle changes or medications, can increase the risk of atrial fibrillation. Thyroid disease. In some people, thyroid problems may trigger heart rhythm problems (arrhythmias), including atrial fibrillation.

• Hereditary and Family History:

  Scientists have found some genes with mutation, which transfer the risk of A-Fib to the descendants.

• Racial Factor:

  Some races are more vulnerable than others. In the United States A-Fib is very common in white Americans, than those who belong to the black race.

• Social Habits: 

  Social habits like excessive use of drugs, alcohol, smoking, and even second-hand smoking exposure may increase the risk of A-Fib. The longer you use the narcotics, the risk appears to be higher. Consumption in large amounts, especially binge drinking, raises your risk of atrial fibrillation. Even modest amounts of alcohol can trigger atrial fibrillation in some people.

• Inadequate Physical Activities:

  Inadequate physical activities like participating in endurance sports or physically working hard, may lead to a higher risk of atrial fibrillation for some people, especially competitive athletes and men. At the same time, moderate physical activity can have a protective effect. Physical fitness appears to be linked to a lower risk of atrial fibrillation.

• Mental Conditions: 

  Stressful situations, panic disorders, and other types of emotional complications may be linked to a higher risk of A-Fib.

• Chronic Health Conditions:

  Scientists associate many other health conditions and disorders with the risk of Atrial Fibrillation. Advancing age along with one or more of the following health conditions may increase your risk;

  • Chronic kidney disease
  • Conduction disorders
  • Congenital heart defects
  • Coronary heart disease
  • Diabetes
  • Heart attack
  • Heart failure
  • Heart inflammation
  • Heart tissue that is too thick or stiff
  • Heart valve diseases
  • High blood pressure
  • Hyperthyroidism, an overactive thyroid gland
  • Lung diseases, including COPD
  • Obesity
  • Sarcoidosis
  • Sleep apnea

• Obesity/ Overweight:

  People with obesity have a higher risk to suffer from A-Fib. Before going through the relationship between obesity and A-Fib, we need to understand what obesity actually is. If your BMI (Body Mass Index) is 18.5 to <25, it falls within the healthy weight range. But if it is 25.0 to <30, it falls within the overweight range. If your BMI is 30.0 or higher, it falls within the obesity range.

  (BMI=Body Mass in Kg/Square of Hieght in meters)

  Regarding heart rhythm disorders, obesity is associated with an increase in atrial fibrillation (AF), the most common arrhythmia in clinical practice. AF is associated with increased cardiovascular morbidity and mortality. Obesity, a novel risk factor, is responsible for a 50%-increased incidence of Atrial Fibrillation.

• Surgery:

  Recent heart, lungs, and esophagus may put you at risk of A-Fib. It is because of muscular tension caused by surgery.

• Thyroid Diseases:

  In some people, thyroid problems may trigger heart rhythm problems (arrhythmias), which may lead to atrial fibrillation.

Complications of Atrial Fibrillation

A-Fibrillation, itself is not a fatal condition. However, it can lead to severe conditions, which may cause serious health complications and even death. Following are the complications associated with AFib.

1. A-Fib and Stroke,
2. A-Fib and Cardiomyopathy
3. Heart Attack, and Heart Failure
4. Dementia/ Memory Loss
5. High Blood Pressure
6. Some Valvular Heart Disease

Can we prevent Complications?

Yes, we can prevent complications caused by A-Fib. Following precautionary measures, and healthy habits can help us prevent other health problems that A-Fib can cause.

• Eat a heart- and brain-healthy diet. Limit salt, saturated and trans fats. Make fruits, vegetables, whole grains, and lean protein the majority of your diet.
• Exercise frequently as per the recommendations of the doctor. Ask your doctor to recommend a suitable exercise plan that has the least impact on your heart.
• Manage blood pressure and cholesterol with a safe diet, exercise, and medicine if you need it.
• One should either reduce or quit smoking. In order to easily avoid smoking, ask your doctor to recommend tips to avoid smoking.
• Limit using alcohol and caffeine.

How can I check for Afib at home?

Atrial fibrillation can be detected easily by the victim themselves. Here are some common symptoms, which help you diagnose A-Fib. After feeling these symptoms, A-Fib can be verified by ECG testing.

1. Fast and pounding heartbeat
2. Extreme fatigue
3. Dizziness and lightheadedness
4. Fainting or Syncope
5. Short Breaths
6. Chest pain
7. A perpetual weakness and tiredness

When should you call a doctor?

A-Fibrillation often causes serious medical complications. So, learning the warning signs and sharing them with other is very necessary, so that a timely cure may be taken out. Following are the warning signs, for which you should call a doctor right away.

Bleeding Signs

• • Bleeding of bright red blood in your vomit, stool, or urine is extremely a sign of danger.
  • Sometimes patient goes through severe pain in the head and abdomen.
  • Drastic changes in vision are the alarm to call for a doctor.
  • Difficulty moving your legs or arms.
  • Losing memory is a sign of warning. In such conditions, one should contact their doctor immediately.

The above-mentioned signs seem as a result of bleeding in the brain, urinary tract, and digestive system. In this complicated situation, one should take blood-thinning medicines. But taking too high a dose can cause bleeding in your body.

Heart attack symptoms

• • An episodic or persistent pain, discomfort, or pressure in the center of your chest or upper abdomen are the signs of a heart attack.
  • The feelings of squeezing, fullness, heartburn, or indigestion also reflect a heart attack.
  • Pain down your left arm.

Females at birth may also have:

• • Nausea and vomiting.
  • Shortness of breath.
  • Excessive tiredness.
  • Pain in the back, shoulders, or jaw.

Stroke symptoms:

Following are the signs of having a stroke. Learning and recognizing the signs of stroke is as important as life itself.

• • Arousal of sudden weakness/numbness on one side of the body.
  • Losing the ability to speak and understand others.
  • Loss of seeing from one or both eyes.
  • Difficulty in walking and keeping the body balance.
  • Feeling dizzy or tired.
  • Sudden and extreme headache for no reason.

Signs of cardiac arrest

• • Angina or Chest Pain
  • Short Breaths
  • Nausea, vomiting, and the burden on Chest,
  • Dizziness or lightheaded.

These are the pre-cardiac arrest symptoms. However, in very rare cases these symptoms may not happen at all, and the person can simply faint (goes unconscious).  The signs of cardiac arrest are a warning sign, especially in patients with A-Fib.

Prevention from Atrial Fibrillation

A healthy lifestyle and health-friendly habits can reduce Atrial Fibrillation in those who suffer from it, and prevent those who have a risk to suffer. Following health-friendly habits should be adopted to prevent all types of heart disorders, especially heart rhythm irregularities.

• Avoid smoking, even secondhand smoking exposure.
• Eat a clean vegetative nutritious diet.
• Avoid or limit the use of alcohol, and caffeine.
• Stress and mental tensions lead to heart problems, so in order to prevent heart disorders, manage stress and anger. Some physical and mental exercises (breathing exercises) can help reduce mental stress. Exercise to achieve concentration will help reduce stress and anxiety.
• Physical exercise throughout the days of the week must be done as a habit. Physical exercise will reduce cholesterol in the blood. However inadequate physical activities like participating in endurance sports or physically working hard may lead to a higher risk of atrial fibrillation for some people, especially competitive athletes.

Cure and Treatment of Atrial Fibrillation

Atrial Fibrillation is not usually life-threatening, however, it needs attention, because it may lead to other life-threatening conditions like stroke, heart failure, dementia, valvular disorder, etc. Being uncomfortable it needs treatment and can be treated by medications, therapeutical resetting of the heart rhythm, and catheter procedures to block faulty heart signals. Atrial Fibrillation may be treated as;

• A heart-healthy diet is the first option to get better.
• As people with atrial fibrillation are more at risk of having a stroke, therefore medicines to prevent a stroke should be taken.
• Apart from healthy diet medicines to regulate the heart rate or rhythm should be taken.
• Cardioversion therapy should be carried out in order to regulate heart rhythm. Cardioversion is a procedure of controlled and low-energy electrical shock to restore the regular heart rhythm.
• Catheter Ablation is a medical therapeutic procedure, where radio frequency energy is used to destroy a particular part of the body. In the case of Atrial Fibrillation, the part of the heart that’s causing the abnormal heart rhythm is destroyed using radiofrequency energy, and then you may need to have a pacemaker fitted to help regularize your heartbeat.

Difference between Atrial Fibrillation and Atrial Flutter

A person with atrial fibrillation may also have a related heart rhythm problem called atrial flutter. Hence atrial flutter is a different arrhythmia, the treatment is slightly different from atrial fibrillation. Atrial Flutter is less severe and less common than Atrial Fibrillation. People with atrial flutter have a tendency to develop AFib, even after treatment. Both conditions share the same symptoms, causes, and possible complications. Some people with atrial flutter also have atrial fibrillation. The rhythm in the atria is more organized and less chaotic than the abnormal patterns caused by atrial fibrillation. Treatment for atrial flutter is also slightly different. Catheter ablation is considered to be the best treatment for atrial flutter, whereas medicine is often the first treatment used for atrial fibrillation.