All you Need to Know About Irregular Heart Beats

Dr. Nathan Ho, Interventional Cardiologist

What is Atrial Fibrillation?

Atrial fibrillation is a condition that involves a disruption in the heart’s normal rhythm. This condition is characterized by uncoordinated electrical activity in the heart’s upper chambers (the atria), which causes the heartbeat to become fast and irregular. During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly out of coordination with the two lower chambers (the ventricles) of the heart. As a consequent of this irregular and often rapid heart rate, there is poor blood flow to the body. Simply put, a heart with atrial fibrillation doesn’t beat efficiently.

This is important because atrial fibrillation is the most common type of sustained abnormal heart  rhythm (arrhythmia). It affects more than 3 million people in the United States.  As many as 12 million people will have the condition by 2050.  The risk of developing this irregular heart rhythm increases with age. In addition, atrial fibrillation increases the risk of stroke and sudden death.

What are the Signs and Symptoms of Atrial Fibrillation?

Some people with atrial fibrillation have no symptoms and are unaware of their condition until it’s discovered during a physical examination.

Those who do have atrial fibrillation symptoms may experience:

• Palpitations (sensations of a racing, uncomfortable, irregular heartbeat or a flopping in your chest)
• Decreased blood pressure
• Weakness
• Lightheadedness
• Confusion
• Shortness of breath
• Chest pain

Is Atrial Fibrillation Genetic?

The incidence of the familial form of atrial fibrillation is unknown; however, recent studies suggest up to 30 percent of all people with atrial fibrillation may have a history of the condition in their family.  Familial atrial fibrillation appears to be inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.  A small percentage of all cases of familial atrial fibrillation are associated with changes in the genes that provide instructions for making proteins that act as channels across the cell membrane. Most cases of atrial fibrillation are not caused by mutations in a single gene.

Atrial fibrillation is, in many cases, related to structural abnormalities of the heart or underlying heart disease.  There are associated risk factors that cause atrial fibrillation.

Risk factors  include:

• Family history: An increased risk of atrial fibrillation runs in some families.
• Age: The older you are, the greater your risk of developing atrial fibrillation.
• Heart disease: Anyone with heart disease, including valve problems and a history of heart attack and heart surgery, has an increased risk of atrial fibrillation.
• High blood pressure: Having high blood pressure, especially if it’s not well controlled with lifestyle changes or medications, can increase your risk of atrial fibrillation.
• Other chronic conditions: People with thyroid problems, sleep apnea and other medical problems have an increased risk of atrial fibrillation.
• Drinking alcohol: For some people, drinking alcohol can trigger an episode of atrial fibrillation. Binge drinking — having five drinks in two hours for men, or four drinks for women — may put you at higher risk.

How is Atrial Fibrillation Treated?

The treatment option best for you will depend on how long you’ve had atrial fibrillation, how bothersome your symptoms are and the underlying cause of your atrial fibrillation.

Generally, one or more of the following are used in the treatment of atrial fibrillation:

• Medications to control the rhythm and rate of the heart
• Surgery (Surgical maze procedure, Radiofrequency catheter ablation)
• Electrical cardioversion.
• Medications to  thin the blood to prevent blood clot formation and reduces the risk of having a stroke – Warfarin(Coumadin), Dabigatran (Pradaxa), Rivaroxaban (Xarelto).
• Lifestyle changes to reduce the risk factors for atrial fibrillation, which include high blood pressure, obesity, and diabetes

The strategy you and your doctor choose depends on many factors, including whether you have other problems with your heart and if you’re able to take medications that can control your heart rhythm.

Dr. Nathan Ho is an Interventional Cardiologist with Carson Tahoe Cardiology.