Paying attention to an irregular heartbeat can be lifesavingSep 23, 2020
September is Atrial Fibrillation Awareness Month and doctors are encouraging people to be aware of the symptoms and to get screened if needed. Atrial fibrillation (Afib) is the most common heart rhythm disorder, affecting millions of Americans. When left untreated, Afib increases a patient’s risk of stroke (fivefold increase), heart failure, and may increase mortality. Common symptoms of Afib include palpitations, shortness of breath, chest discomfort, fatigue, and feeling dizzy or lightheaded. Some patients may have no symptoms but are still at risk of complications of Afib. Fortunately, therapy for Afib has improved dramatically over recent years and much can be done to improve symptoms, limit risk of complications, and in some cases eliminate atrial fibrillation.
Electrophysiologists are heart doctors with specialized training on the heart’s electrical system. Their role is to diagnose and treat patients with electrical problems in the heart and the heart rhythm disorders (arrhythmias) they cause.
“During atrial fibrillation, the electrical activity in the atria (the upper chambers of the heart) is chaotic and disorganized, so the atrial quiver instead of contracting. Blood tends to pool, which can form clots. Those clots can break off and go to the brain and cause a stroke,” said Stephen May, M.D., FHRS, medical director of cardiac electrophysiology at Baptist Health System. “Also, electrical signals that reach the ventricles (the bottom chambers of the heart that do most of the pumping) can be too fast, too slow, or irregular, which makes the heart a less efficient pump.”
Treatment for atrial fibrillation starts with exploring the causes and correcting or improving the factors that contribute to atrial fib, such as heart failure, valve disease, obesity, and high blood pressure.
Everyone with atrial fib needs to have his or her risk of stroke assessed to determine if blood thinners should be started to reduce the risk of stroke. Most patients with atrial fibrillation should be on blood thinners, and aspirin alone is not enough in most cases. For patients that cannot tolerate blood thinners but are at increased risk of stroke, a new device called the Watchman, can be implanted to seal off the left atrial appendage and lower the risk of stroke without the need for long term prescription blood thinners.
Heart rates for patients with atrial fibrillation should be kept in a range similar to patients without atrial fibrillation, roughly 60-100 beats per minutes. Medications can usually achieve this, but sometimes pacemakers or other procedures are necessary.
For patients with significant symptoms of atrial fib, or when atrial fib is complicating other medical conditions such as heart failure, an approach to try to reduce the amount of atrial fib and keep the patient in normal rhythm can be helpful and is frequently recommended. This may involve particular medications such as antiarrhythmic medications, cardioversions, and/or atrial fibrillation ablation. Afib ablation is a catheter-based procedure done by electrophysiologists in the electrophysiology lab. The electrophysiologist uses small spaghetti-sized catheters to go from the veins in the legs, up to the patient’s heart, to find and destroy (ablate) the abnormal areas that are causing the atrial fibrillation.
68-year-old Raymond Gaidusek ended up in the Emergency Room multiple times because his heart was beating too fast and was out of rhythm. “Medications only worked for a little while,” Gaidusek said. “Then I found a doctor who specialized in my problem and he was able to correct it with a simple procedure. I was up and walking around the next day after surgery and I’ve been doing well with no problems ever since,” he said.If you or someone you know has atrial fibrillation or has symptoms suggesting atrial fibrillation, we recommend you discuss your concerns with your doctor and consider evaluation with one of our heart rhythm experts. Baptist Health System offers advanced treatments for AFib and other arrhythmias at Baptist Heart and Rhythm Centers. State-of-the-art, minimally-invasive therapies offered by cardiac electrophysiologists provide patients with minimally-invasive therapies that can restore normal heart rhythm. These treatments can help patients get off of medication and back to life again. The Heart and Rhythm Centers also offer electrophysiology studies, ablations as well as pacemakers and defibrillators implants.
Source: U.S. Centers for Disease Control and Prevention