What is atrial fibrillation?
Normally, the heart pumps in a coordinated fashion. The two upper chambers
(atria) contract first, followed by the two lower chambers (ventricles).
This synchronous pumping is controlled by the heart's own electrical
system and efficiently pumps blood out to the body and back.
In atrial fibrillation (AF), a type of arrhythmia, the atrial signals fire
rapidly and chaotically. This causes the atria to quiver instead of contracting
normally. The signals then reach the ventricles, causing them to contract
fast and irregularly too. Over time, this can weaken the heart and lead
to heart failure. Plus, when the atria do not contract effectively, blood
may pool in the heart, increasing the risk that a blood clot may form
in the atrium and travel to the brain causing a stroke – people
with AF are 5 to 7 times more likely to have a stroke than people who
do not have AF. AF may also cause a reduction of 20 percent of cardiac output.
AF is more common in people who are over 65 and is seen more often in men
What are the symptoms of atrial fibrillation?
You may not have symptoms with AF, but when ventricles are not able to
pump enough blood out to the lungs and body, it can cause these symptoms:
- Heart palpitations or fluttering in the chest
- Chest pain
- Shortness of breath
- Dizziness and faintness
Some people with AF have intermittent episodes (paroxysmal AF). Others
have chronic or persistent AF.
What causes atrial fibrillation?
AF can develop when someone who has underlying heart disease, such as heart
valve disease, heart attack, or heart failure. High blood pressure, thyroid
problems, excess alcohol use, sleep apnea, and certain lung diseases can
also cause AF. It may also occur without organic heart disease.
How is atrial fibrillation treated?
Some people with atrial fibrillation will return to normal rhythm without
treatment. They will "convert" on their own back to normal rhythm.
Treatment decisions depend in part on whether symptoms are bothersome
and how long your heart has been in AF. For most people, treatment of
AF involves attempts to restore (reset) the heart back to its normal rhythm
(rhythm control) or to control the heart rate (rate control). Sometimes
surgery or a procedure called catheter ablation is used. In addition,
a person with AF is given medications to prevent blood clots to reduce
the risk of stroke.
Rhythm control. Rhythm control is an attempt to reset the heart back to its normal rhythm.
It can be done with medications or electrical shock.
- Anti-arrhythmic medications
- Electrical cardioversion involves sending an electrical shock through paddles
placed on the chest. Usually doctors will want you to take blood thinners
for a period of time before electrical cardioversion to reduce the risk
of a stroke from a dislodged blood clot.
Rate control. Medications to help control the heart rate include:
- Beta blockers, such as atenolol or metoprolol. These drugs slow the heart rate.
- Calcium channel blockers, such as diltiazem or verapamil. These drugs slow
the heart rate.
Catheter ablation. In this procedure, a catheter is guided through a blood vessel to the
heart. Here energy is sent through the catheter to isolate small areas
of heart tissue responsible for the arrhythmia. It may be an option when
medications are not working.
Maze procedure. This is a surgical procedure in which areas of the heart are isolated
to create a "maze" of scar tissue that prevents the erratic
electrical signals from passing through the heart. A Hybrid Maze procedure
is also available - this is a minimally invasive procedure that often
involves shorter recovery times.
Treatment to prevent blood clots. People with AF will be prescribed blood thinners to reduce the risk for
stroke. This may include aspirin, warfarin, dabigatran, or rivaroxaban.
Your doctor will have a detailed discussion with you about which blood-thinning
medications are most appropriate for you.
For a referral to a RWJBarnabas Health cardiac specialist, call 888-724-7123.
For more information about atrial fibrillation, visit healthlibrary.barnabashealth.org.
RWJBarnabas Health – Treating More Cases of AF Than Any Other Program
in New Jersey
The Atrial Fibrillation Center, located at Newark Beth Israel Medical Center
in Newark and Saint Barnabas Medical Center in Livingston, is New Jersey's
finest and most comprehensive program dedicated to the treatment of atrial
fibrillation Our experienced team of specialists offers the most sophisticated
cardiac diagnostic imaging technology, as well as the most effective therapies
and advanced treatments.
As New Jersey's leader in cardiac services, we treat more cases of
atrial fibrillation than any other program in New Jersey.
The treatment of atrial fibrillation is multi-faceted. Our experienced
team of physicians offers the clinical expertise that patients need for
precise diagnosis and optimal treatment. This customized care begins with
referral from a patient's cardiologist or primary care physician.
After receiving the patient's medical records and cardiac test results,
our team of cardiothoracic surgeons and electrophysiologists consult with
the referring physician in a complete clinical assessment.
This collaborative review also addresses problems that may otherwise be
overlooked – problems that may be contributing to Afib or affecting
overall cardiac health. As a result, each patient receives a comprehensive
assessment of cardiac health, and is assured of the most appropriate treatment
plan, with the most effective options for his/her particular situation.
For more information about the Atrial Fibrillation Center, call 1.866.549.AFIB