You just found out you have A-fib (atrial fibrillation). What in the world is that and should you be buying your headstone?

When a person suffers from A-fib this means an uneven and usually swift heart rate occurs leading to meager blood flow throughout the body, which is not good. 

Some people have A-fib and aren’t symptomatic. They are unaware they have the condition until physically examined and a doctor informs them. 

Those who are symptomatic can experience heart palpitations that include feelings of flip-flopping in the chest, uncomfortable and irregular heartbeats or a racing heart. 

Other symptoms consist of fatigue, weakness, dizziness, unsteadiness, less capacity to exercise, feeling mentally muddled and shortness of breath and chest pain, according to The Mayo Clinic

There are those who have sporadic episodes, which is called paroxysmal atrial fibrillation. The symptoms ebb and flow, lasting a few minutes or a few hours and then vanish with no intervention 

Persistent A-fib means the normal heart rhythm will not resume without intervention. The person may need medications to reestablish the regular rhythm or require an electrical shock. Yes, that’s a scary thought. 

If an individual has permanent A-fib this means standard heart rhythm cannot be reinstated. Medications are necessary, including blood thinners, averting blood clots. 

How does this work?

When experiencing A-fib, the heart’s atria or two upper chambers beat erratically and indiscriminately and are out of sync with the ventricles, which are the two lower heart chambers. 

The heart possesses a natural pacemaker which is the sinus node, a cluster of cells in the right atrium. 

The node emits the impulse that as a rule starts each heartbeat. The stimulus travels through the atria first and then through the atrioventricular (AV) node, which is the uniting conduit between the upper and lower chambers of the heart. 

As the impulse moves from the sinus nod through the atria, contraction takes place and blood is pumped from the atria into the lower ventricles.

As the impulse makes its way through the atrioventricular node to the ventricles it tells the ventricles to contract, which pumps blood to the rest of the body.

When A-fib takes place, the upper chambers undergo disordered electrical signals and begin to shudder. This causes the electrical connection between the atria and the ventricles (the AV node) to be blitzed with impulses trying to get through to the ventricles. 

The atria beats speedily, as do the ventricles, although not quite as fast as the atria. Some of the impulses cannot get through. There is a traffic jam: Only so many signals can get through at one time. 

This leads to an unbalanced and fast heart rhythm of up to 175 beats per minute. The normal range is 60 to 100 beats a minute. 

Those with A-fib do not automatically have heart damage or any heart defects. When this is the case, this is referred to as lone atrial fibrillation. The cause is not known and serious complications are not likely. 

This condition isn’t necessarily life-threatening but it isn’t something you want to ignore. In some circumstances, it necessitates emergency treatment.

Similar to A-fib yet different is atrial flutter, which means the atrial beat is more systematized and less chaotic then the irregular patterns common with A-fib. However, this condition can develop into A-fib, or vice versa. Strokes are a worry for those with atrial flutter. The condition is not typically life-threatening if it is appropriately treated. 

The danger of A-fib is it can lead to blood clots developing in the heart. These clots can travel to other organs and result in ischemia, which is blocked blood flow. 

Why do you have this condition?

There are many risk factors. If an individual has heart damage or abnormalities this increases his risk for A-fib. 

Other causes include:

  • Having had a heart attack
  • High blood pressure 
  • Coronary artery disease
  • Metabolic imbalances or an overly active thyroid gland 
  • Lung disease
  • Sick sinus syndrome, which means incorrect functioning of the heart’s natural pacemaker
  • Congenital (born with) heart defects
  • Exposure to alcohol, tobacco, caffeine or medications that are stimulants and speed up the heart
  • Abnormal heart valves
  • Sleep apnea
  • Viral infections
  • Stress brought on by illness, surgery or pneumonia 
  • Prior heart surgery

Other factors can up your chance of developing A-fib, including your age. If you have a history of heart disease this puts you at higher danger. Those with high blood pressure are also in peril.

Binge drinking can bring on an episode as can simply drinking alcohol.

If you are suffering from diabetes, lung disease, chronic kidney disease, thyroid issues, metabolic syndrome or sleep apnea, which are all considered chronic conditions, you are in jeopardy of A-fib.

Those who are obese are in increased peril as are those with a family history of A-fib.

Treatment

The Cleveland Clinic has a center for the treatment of atrial fibrillation. Medicine is often used to treat this condition including antiarrhythmic drugs (rhythm control medicine) which enables the heart to return to the normal sinus rhythm or maintain it. You may have to remain hospitalized for a few days when first starting rhythm control medication because the heart must be closely monitored. 

Other types of medication that may be prescribed include rate control medications (such as a beta blocker or digoxin) as well as calcium channel blockers, which slow the heart rate during an episode of A-fib. These drugs do not regulate heart rhythm but do prevent the ventricles from beating too hurriedly. 

Medicine that prevents blood clots is called an anticoagulant. Antiplatelet therapy medicines do likewise. One or both may be prescribed. 

If the medicine doesn’t work, there are procedures for treating abnormal heart rhythm including pulmonary vein antrum isolation, electrical cardioversion (electrical shock), ablation of the AV node after which a pacemaker in put into the body, or surgical ablation (which is minimally invasive and referred to as the Maze procedure.)

Steps you can take on your own

Stop smoking, don’t drink too much alcohol if any, tell your physician when you experience A-fib (as in what activities seem to prompt it); be cautious about stimulants (caffeine.) Cold medication often contains stimulation which can up the risk of A-fib. Lose weight.

 

Cindi Pearce is a graduate of Ohio University, where she received a bachelor’s degree in journalism back in the dark ages (aka before computers, the Internet and cell phones. Heck, before electric typewriters!) A former newspaper writer/columnist and photographer, her fiction and non-fiction work has been published in national magazines. A full-time freelance writer, as well as an avid gardener, an artist and yoga aficionado, Cindi is a Baby Boomer and proud of it. She has survived the gnarly challenges of the sandwich generation and lived to tell the tale. Cindi has somehow managed to stay married to her first and only husband for nearly 35 years. They are the parents of three grown children and the grandparents of one. She has five large, raucous dogs, five acres to mow on her beloved zero turn mower, and gets the biggest kick out of making people laugh on Facebook. (P.S. She refuses to cut her hair short.)