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Atrial Fibrillation



Atrial fibrillation

Atrial fibrillation (AFib) is a common heart rhythm disorder characterized by irregular and often rapid heartbeats. It occurs when the upper chambers of the heart, called the atria, quiver or fibrillate instead of contracting normally. This irregular electrical activity can lead to various symptoms and, if left untreated, increase the risk of stroke, and other complications like heart failure.



Key points about atrial fibrillation include:

1. Types of AFib: There are different types of AFib, including:
– Paroxysmal AFib: Occasional episodes that start and stop on their own within 7 days
– Persistent AFib: Continuous AFib lasting for more than 7 days
– Long-standing persistent AFib: Continuous AFib lasting for more than a year.
– Permanent AFib: Continuous AFib where attempts to restore normal rhythm were unsuccessful or are no longer pursued.

2. Common Symptoms: Symptoms of AFib can vary and may include:
– Irregular and rapid heartbeat.
– Palpitations (awareness of the heartbeat).
– Fatigue.
– Shortness of breath.
– Chest pain or discomfort.
– Dizziness or fainting.

Risk Factors include age, high blood pressure, heart disease, obesity, diabetes, and a history of heart surgery or other heart conditions. AFib can lead to serious complications, most notably an increased risk of stroke due to the formation of blood clots in the atria. Other complications may include heart failure and an increased risk of other heart-related conditions. Diagnosis of AFib involves a physical examination, an electrocardiogram (ECG or EKG) to record the heart’s electrical activity, and other tests like Holter monitoring or event monitoring to capture intermittent episodes.

The commonest ways to management of AFib involve various medications to control heart rate, rhythm, and reduce the risk of stroke. It is also important to include lifestyle modifications, like dietary changes, weight management, and exercise to control Afib. Blood thinners (anticoagulants) are essential to prevent blood clots and reduce the risk of stroke

There are a few procedures that can be employed for treatment of Afib that is not controlled with medications and lifestyle changes. 

  • Electrical cardioversion to restore normal rhythm.
  • Ablation Therapy
  1. Catheter ablation to destroy the abnormal electrical pathways. This can be done with Radiofrequency energy or Cryo energy. Dr.Nikhil say, “Paroxysmal Afib is best treated with catheter ablation. However in Persistant Afib and especially Long Standing Persistant Afib, Catheter ablation has high failure rates”.
  2. Surgical ablation – Cox Maze 4 procedure : Dr.Nikhil says, “Cox Maze IV is the gold standard treatment for all types of Afib. Though it is open surgery it has shown consistent results!”
  • Implantation of a pacemaker or other devices to manage heart rate or rhythm.

The choice of treatment depends on the type of AFib, the severity of symptoms, and the patient’s overall health. It is essential to work with a healthcare provider, typically a cardiologist, to create a treatment plan that addresses the specific needs and goals of the individual.

AFib is a chronic condition that often requires long-term management, and ongoing medical supervision is crucial to ensure the best outcomes and to reduce the risk of complications.