In a normal and healthy heart, the four chambers contract (squeeze) in a very organized way. This helps the heart pump all the blood the body needs. In atrial fibrillation, the electrical impulse of the heart is not regular. The upper chambers of the heart beat irregularly and rapidly – at 300 beats per minute – and out of coordination with the two lower chambers of the heart. As a result, the heart may not pump enough blood to meet the body's needs. This causes poor blood flow, resulting in symptoms such as fatigue and shortness of breath. Up to 5 million people in the United States suffer from atrial fibrillation, making it one of the most common heart rhythm disturbances. It can affect both men and women and becomes more common as you get older.
Alegent Creighton Health's six metro hospitals have been granted full atrial fibrillation certification by the Society of Chest Pain Centers (SCPC).
Atrial Fibrillation Symptoms
You may not be aware that your heart is not beating in a normal pattern. Symptoms may start or stop suddenly. This is because atrial fibrillation may stop or start on its own.
Symptoms may include:
Atrial Fibrillation Tests
Your doctor may hear a fast heartbeat while listening to your heart with a stethoscope. Your pulse may feel fast, uneven, or both. The normal heart rate is 60 - 100, but in atrial fibrillation/flutter the heart rate may be 100 - 175. Blood pressure may be normal or low.
An ECG — a test that records the electrical activity of the heart — may show atrial fibrillation or atrial flutter. If your abnormal heart rhythm comes and goes, you may need to wear a special monitor that records the heart's rhythms to help diagnose atrial fibrillation. These monitors include:
Tests to find heart disease may include:
Atrial Fibrillation Treatment Options
MedicineDaily medicines taken by mouth may also be used to slow the irregular heartbeat. These medications may include beta-blockers, calcium channel blockers, and digoxin. Medicines may also be used to keep atrial fibrillation from coming back. These medications may work well in many people, but they can have serious side effects. Many patients go back to atrial fibrillation, even while taking these medications.
Blood thinners — such as heparin, warfarin (Coumadin), apixaban, and dabigatran (Pradaxa) — reduce the risk of a blood clot traveling in the body (such as a stroke). Because these drugs increase the chance of bleeding, not everyone can use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your doctor will consider your age and other medical problems when deciding which drug is best.
ProceduresTo help get the heart back into normal rhythm right away, electrical cardioversion may be used. This may involve electrical shocks or special drugs given through the veins. They may be done as an emergency, or planned ahead of time.
A procedure called radiofrequency ablation can be used to destroy areas in your heart that may be causing your heart rhythm problems. You may need a heart pacemaker after this procedure.