Atrial Fibrillation
What Is It?
Atrial fibrillation is a type of cardiac arrhythmia, which is an abnormal heart rate or rhythm. Atrial fibrillation causes a rapid and irregular heartbeat, during which the upper two chambers of the heart that receive blood (the atria) quiver or "fibrillate" instead of beating normally.
Prevention
Atrial fibrillation resulting from coronary artery disease can be prevented by taking these actions to modify your risk factors:
* Eat a low-fat diet.
* Control cholesterol and high blood pressure.
* Do not drink more than two alcoholic drinks per day.
* Quit smoking.
* Control your weight.
* Get regular exercise.
Some causes of atrial fibrillation cannot be prevented.
Treatment
Treatment depends on the cause. If the cause is coronary artery disease, treatment may consist of lifestyle changes, medications that treat high blood cholesterol and high blood pressure and/or procedures such as angioplasty and coronary artery bypass surgery. Atrial fibrillation caused by thyrotoxicosis can be treated with medication or surgery. Atrial fibrillation caused by rheumatic heart disease may be treated by surgery to replace damaged heart valves.
The irregular heartbeat can be treated with medications, such as diltiazem hydrochloride (Cardizem), digoxin (Lanoxin) or verapamil (Tarka), which slow the heart rate. Another treatment option is electrical cardioversion, a procedure that delivers an electrical shock to the heart to restore normal heart rhythm. Although this procedure works in most cases, between 50 percent and 75 percent of patients eventually develop atrial fibrillation again. Drugs such as amiodarone (Cordarone), procainamide (Procan SR, Promine, Pronestyl) or quinidine (Cardioquin, Quinaglute Dura-tabs, Quinidex Extentabs, Quin-Release) may be given to try to prevent atrial fibrillation from returning.
When medications don't work, a procedure called catheter radiofrequency ablation sometimes can be done. In this procedure, an area of tissue in the atrioventricular node is destroyed to prevent excess electrical impulses from moving from the atria to the ventricles. The procedure often completely blocks all electrical impulses. A pacemaker is then implanted to control heart rate and rhythm.
In another surgical procedure, scars are created in the upper chambers of the heart to prevent abnormal electrical activity from spreading and causing atrial fibrillation. This procedure can by done during heart surgery if the patient needs surgery for some other reason, or without surgery through the use of special catheters. However, this approach is relatively new, and physicians are not recommending it as the first approach to atrial fibrillation thus far.
In addition to the treatments described above, people with atrial fibrillation often are given medications to prevent blood clots that can lead to stroke, pulmonary embolism and other complications. This usually includes anticoagulant medications (blood thinners), such as aspirin and warfarin (Coumadin).
