On overview on atrial fibrillation

Background

Dr. William Harvey discovered the circulatory system in 1628. The heart consists of four chambers the left auricle, right auricle, right ventricle and left ventricle. The right and left chambers do not communicate and are separated by the middle septum. The right auricle opens into the right ventricle through a valve to ensure unidirectional flow to the ventricle. Similar is the case with the left chambers. Blood from different parts of the body, except the lungs, received in the right auricle is forced down to right ventricle during contraction. The left side picture is identical except the blood received is from the lungs after due oxygenation and carbon dioxide degassing.

On ventricular contraction the blood from right ventricle is forced through the lungs while that from the left is circulated all over the body. Needless to say, the contractions of the auricles are simultaneous and are followed by the ventricles. These contractions need to be closely coordinated for problem free blood circulation. There is a network of nerves and a control centre called the Sinoatrial Node located at the top upper wall of the right atrium close to the opening of the main vein. By and large this coordination is autonomous and is known as sinus rhythm. The central nervous system can and do interfere as and when required.

Heart gets a wink of rest between beats,

Atrial fibrillation

Atrial fibrillation, or afib, is a condition in which the auricular contractions go out of synchronization and become haphazard and rapid. Though, it is rarely fatal by itself it increases the risk of heart failure, stroke and other heart complications. Atrial fibrillation may be occasional and transient or may be persistent. When occasional it is termed paroxysmal. It comes and goes back to normal. In persistent type the heart does not go back to normal and calls for medical intervention as it can lead to emergency. It can cause formation of clots which on migration can cause embolisms which are serious conditions. Symptoms can be silent in certain cases. Palpitation, which is a sensation of racing, a flip-flopping sensation in chest or uncomfortable irregular heartbeat. Weaknesses, reduced ability to exercise, confusion, dizziness, fatigue, lightheadedness, shortness of breath are some other symptoms. In case one experience atrial fibrillation should meet his doctor. In case there is chest pain, it indicates that a heart attack is taking place and should get emergency medical aide.

What does afib treatment do?

Atrial fibrillation treatment is to bring back the rhythm to normal or control the rate, prevent clot formation in the atrium and decrease the risk of stroke. The strategy adopted however depends on a number of factors like whether there are any other underlying cardiac problems and one can take the required medication continuously. Sometimes it may be necessary to resort to more invasive procedures using catheters or even surgery. Atrial fibrillation medications are drugs employed to bring the heart back to normal rhythm. This process is called cardioversion. The other method often resorted to in emergencies is Electrical cardioversion. The patient is sedated and shock is delivered to the heart by paddles or patches placed on chest. This momentarily stops the heart and it is hoped that it will restart with normal rhythm. Normally, a blood thinner may be given prior to cardioversion. The medications used are called anti-arrhythmic. Some of the drugs are Dofetilide, Propafenone, Flecainide, Sotalol, Amiodarone etc.

Where medications fail to bring the heart to the normal sinus rhythm then catheter based invasive treatment needs to be instituted. In this a catheter is introduced in the groin, femoral vein, and threaded up to the right atrium. Atrial fibrillations, in these cases are caused by Sinoatrial node like tissues in the atrial wall sending rapid signals. This causes the auricles to beat rapidly and out of sync. These signals are called ectopic. The ablation catheter has tips which can emit radio frequencies to burn out these tissues. Extreme cold, cryotherapy, or heat also is used to burn off these tissues. Surgical maze is another procedure done in open heart surgery, normally making use of an opportunity. Several precision incisions are made on the atrial walls creating a pattern of scar tissue. These tissues do not allow electrical signals to pass through. Since open heart surgery is required it is done only when everything else fails. The Atrial fibrillation can occur in these patients too sometimes needing other treatments.

Atrial fibrillation stroke medications are given during and later in life to prevent clot formation. The medicines are Warfarin, Dabigatran Rivaroxaban and Apixaban are some of the drugs. The doctor’s instructions need to be strictly followed in using them as they have limitations and side effects. All said and done atrial fibrillation is not life is not fatal and with medication and changed life style one can live a near normal life