Arrhythmia comprises several conditions that result in an abnormal heartbeat. These can range from normal and natural to severe and life-threatening. One of the most prolific and common of these arrhythmias is atrial fibrillation, which becomes an increasing health risk as one grows older. Unfortunately, atrial fibrillation falls into the category of severe arrhythmias, sometimes leading to life-threatening consequences for those who suffer from it.
What is atrial fibrillation, and how does it work?
Atrial fibrillation strikes when the mechanism responsible for your heartbeat no longer operates properly. In your heart, there are the upper and lower chambers. As the heart beats, blood travels from the top to the bottom of the heart so it can be "pumped" to the rest of your body. This must happen at a proper pace, which is why your heart pumps faster when you're doing something strenuous. If your heart beats too fast however, it can't fill with blood before it pumps it to the rest of your body.
The thing controlling your heartbeats is called the sinoatrial node. The sinoatrial node sends electrical signals to your upper and lower chambers to contract when the heart needs to beat. It can be comapred to the pedal of a car that triggers the mechanisms for the car to move. When someone has atrial fibrillation, the electrical signals are no longer organized and fire erratically, telling the upper chambers to contract at random times. This can be up to five times faster than regular heartbeats, and the upper chambers can't keep up. They are no longer able to fill with blood properly. Fortunately, the body has a natural failsafe to stop the lower chambers from beating as erratically, but they still beat faster than usual.
Is all atrial fibrillation the same? Are there different types?
Paroxysmal Atrial Fibrillation
Paroxysmal atrial fibrillation an episode of atrial fibrillation that lasts less than seven days. It ends spontaneously within that period, although it is recurrent, so it can occur again within the same seven days while still being paroxysmal. Usually, this type of atrial fibrillation lasts less than 24 hours, sometimes only seconds to minutes. However, these episodes can also strike repeatedly for years. Usually, people with this type will have more symptoms.
Persistent Atrial Fibrillation
Persistent atrial fibrillation are episodes of atrial fibrillation that last longer than seven days, but not as long as a year. However, unlike paroxysmal atrial fibrillation, which will end on its own, persistent atrial fibrillation generally lasts until medications are used or cardioversion is performed. This involves delivering electrical shocks to the heart to restore it to its normal pace.
Permanent Atrial Fibrillation
Unlike the other two, this type of atrial fibrillation cannot be corrected. Cardioversion and medications do not restore the heart to its normal rhythm, and it is designated permanent. This type of atrial fibrillation requires other types of treatment to reduce the life-threatening symptoms.
What kind of symptoms could I expect from these arrhythmias?
Even if you have atrial fibrillation, you may not be aware of it. Atrial fibrillation can cause your heart to beat abnormally without any symptoms at all. The symptoms may also start and stop suddenly if you have persistent or paroxysmal atrial fibrillation. Naturally, not all these symptoms have to be present to have atrial fibrillation. In fact, the most common symptom is simply fatigue.
The symptoms of atrial fibrillation may include:
- Heart palpitations
- Difficulty breathing, especially when laying down
- Heart or chest pain
- Low blood pressure
- Dizziness and lightheadedness
- Inability to exercise
In addition, the heart improperly carrying blood throughout your body can cause strokes and build up blood clots. This requires immediate medical attention.
How would a doctor treat these symptoms?
At first, a doctor may administer drugs or electric shocks (cardioversion) to restore proper behavior to the heart. For more permanent solutions, drugs to slow the heartbeat and what is called radiofrequency ablation can be used. Sometimes the drugs do not work, and atrial fibrillation returns. Ablation can remove the problematic parts of the heart by scarring them over. This may stop the atrial fibrillation.
For those who do not respond well to these treatments, blood thinners can be administered. Although this won't cure atrial fibrillation, they can prevent life-threatening blood clots from forming. Finally, there is an option to use what is called a "watchman device". It's a device that can be placed in the heart to catch blood clots. As with all treatments, a doctor should be the one to recommend and prescribe them to you.