What are the Treatments for Atrial Fibrillation?

Treatments for Atrial Fibrillation

Atrial Fibrillation is one type of a set of conditions involving abnormal heartbeat called arrhythmias. Worldwide, Atrial Fibrillation is the most common type of arrhythmia and also the primary cause of stroke.  To help understand Atrial Fibrillation, here are some important details including methods to treat irregularly heartbeat caused by the said heart condition.

A person’s normal heart rate (at rest) is expected to be regular, with a range of 60-100 beats in a minute. In the case of someone having Atrial Fibrillation, a person will manifest irregular and fast heart rates of over 100 beats per minute. Because of the erratic and irregular beating of the heart, Atrial Fibrillation will result, where the heart will ineffectively pump blood since the atria (upper chamber of the heart) will not be in-sync with the ventricles (lower chambers of the heart). 

The abnormal beat of the atria is commonly related to structural problems in the atria itself and other heart-related conditions such heart failure, high-blood pressure, heart valve disease, congenital heart defects, coronary artery disease, etc. Additionally, there are cases where the cause of Atrial Fibrillation is not heart-related like lung cancer or disease, an infection, sleep apnea and even the use of alcohol, caffeine, tobacco and other stimulants. 

Aside from irregular and fast heart rates, here are additional common symptoms of Atrial Fibrillation:

  • experiencing dizziness or fainting, tiredness/fatigue and shortness of breath
  • noticeable palpitations of the heart where it feels like it is pounding, fluttering or abnormally beating that lasts for a few seconds or even minutes in some instances
  • chest pains

It is important to note though that sometimes, in some people, there are no symptoms at all. 

Atrial Fibrillation can be classified according to the following:

  • Paroxysmal (Occasional) where the symptoms are recurring and  last for a a number of  minutes to hours. Episodes can happen repeatedly and can last weeklong. There are cases where the symptoms just disappear without intervention. 
  • Persistent where the rhythm of the heart does not regulate by itself and medical intervention is necessary to bring back the heart’s normal heart rate and maintain it.
  • Long-standing persistent where the condition is continuous and will last longer than a year
  • Permanent where the heart rate cannot be brought back to normal, and require medication to prevent serious complications such as blood clots.

Like any other disease, there are certain groups of people more likely to develop Atrial Fibrillation than others, and they are:

  • Older people
  • People with existing diseases of the heart
  • People with diabetes and obesity
  • Those who have higher consumption of alcohol
  • People who smoke
  • People with a family history of Atrial Fibrillation
  • People with high-blood pressure
  • Those with other serious medical conditions
  • Those Having thyroid disease

When experiencing symptoms such as pain in the chest, one should seek medical attention right away. Similarly, since not all may have symptoms of Atrial Fibrillation to trigger awareness, there is really a need to see a doctor for proper diagnosis. To diagnose, the doctor will perform physical examinations and diagnostic tests such as:

  • Electrocardiogram (ECG)-this is the main diagnostic test utilized for atrial fibrillation detection where the electrical activities of the heart are measured. This is a painless and quick test that can show if the heart is beating normally or not (i.e., too fast, slow, or irregularly).  
  • Blood tests-this is done to identify if the symptoms are not related to a thyroid issue or to see substances in the blood related to Atrial Fibrillation
  • Use Holter monitor and event recorder-these are devices designed to monitor the heart’s activity, including irregular heart beats.
  • Stress test (exercise testing)-this test is done during exercise using a stationary bike or treadmill
  • Echocardiogram-this test makes use of sound waves to create images of the size, structure and motion of the heart
  • Chest X-ray-used by doctors to see lung and heart conditions

With proper diagnosis, appropriate treatment will then be administered. Treatment for Atrial Fibrillation ranges from use of medicine to surgery, including the use of implants. The treatment offered will mainly depend on what causes the Atrial Fibrillation and how serious it is. Common treatments for Atrial Fibrillation includes:

  • The use of Medication to control heart rate, make heart beat slower/regular and prevent blood clots to reduce risk of getting a stroke. Here are the medications used to treat Atrial Fibrillation:
    • beta blockers for to help make the heart beat slow during an activity and at rest
    • Calcium channel blockers used to regulate heart rate (not suggested to those who have low blood pressure and heart failure)
    • Dixogin used most effectively to control heart rhythm at rest
    • Anti-arrhythmic drugs are medications that can maintain normal heart rate aside from controlling it. 
    • Blood thinners to reduce risk of stroke or possible organ damage from blood clots
  • Therapeutic procedures such as catheter ablation are used when the patient is experiencing adverse side-effects from certain medication or if medication is not enough. 
  • Therapy through Cardioversion where the abnormal or irregular heart rates are brought back to normal through use of electrical cardioversion or drug cardioversion. An electrical cardioversion will involve use shock (of high energy) that is passed to the heart with use of patches placed on a patient’s chest. A drug cardioversion, on the other hand involves use of medicine (oral or intravenous) to restore heart rate to normal.
  • Surgery for cases that are complicated or serious. The surgical method used most frequently is called the Maze Method where a few incisions are made the heart’s atria to avoid irregular impulses from affecting the said part of the heart. The other method for surgery is the Atrioventricular (AV) node ablation where heat or cold energy is applied to the tissues of the heart to correct Atrial Fibrillation. Patients who have undergone AV Node ablation will require a pacemaker (an implanted device to regulate heart rate) for life. 
  • Lifestyle changes may also be suggested by your doctor to make improvements to your health such as to quit smoking and lessening alcohol intake, etc. 

Maintaining a healthy heart is really very important. Seek medical attention once experiencing symptoms or in doubt about your health. Early detection of a disease or condition is vital for effective treatment and chance of survival.

Cadence Heart Centre

Mt. Elizabeth Hospital, 3 Mount Elizabeth #14-13

Mt Elizabeth Medical Centre, Singapore 228510

Mobile: (65) 8318 9884

Phone: (65) 6369 8789

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