Atrial fibrillation

This common heart rhythm disorder affects 5 percent of Australians over age 65. Today, thanks to highly effective treatments, most people with AF are able to get their heart beating regularly and drastically reduce the risk of developing serious complications.

What is happening

Much the way a car engine runs smoothly only when its spark plugs are calibrated to fire in proper sequence, your heart depends on a regular, well-coordinated discharge of electrical impluses in order to beat properly. When its natural electrical conduction system is disrupted for any reason, you may experience an irregular heart beat, or cardiac arrhythmia. One of the most common of these is atrial fibrillation, also known as AF.
    This problem occurs in the atria, the two upper (and smaller) chambers of the heart. When your heart is functioning properly, the atria empty blood into the lower chambers (the ventricles) by a forceful pumping contraction (your heartbeat), which is triggered by a single electrical impulse. If the impulses are too small and weak, the result is a series of rapid, uneven contractions, which aren't strong enough to pump the blood forward. This unstable situation, called atrial fibrillation, can be constant or can occur in episodes that alternate with normal heart rhythm.

LIKELY FIRST STEPS

• Proper evaluation of your symptoms by a cardiologist  to get your treatment regimen off on the right foot.
• Anticoagulant drug therapy to prevent stroke.
• Medications to restore normal heart rate and rhythm.
• For some, a brief electric shock to jolt the heart back into its normal rhythm (called cardio-version).

  Although AF is not particularly  dangerously in itself, it can cause unpleasant symptoms and lead to potentially serious complications. During an AF episode, the contractions of atria are so rapid and chaotic that the atrial walls simply quiver (fibrillate), rather than pump. As a consequence, your heart then cannot keep up with your body's demand for blood. You may feel weak, dizzy or short of breath, you may also experience heart paipitations or chest pains.

QUESTIONS TO ASK

• Are there certain activities (e.g., sports or sex) I should avoid? And for how long?
• Are there other changes in my lifestyle that I should be making?
• Am I a candidate to take an anticoagulant?
• Will I need a pacemaker?

Treatments

Firstly patients need to be check out to exclude other treatable causes of AF such as thyroid disease or valve lesions. In many cases, no special treatment is required for an occasional episode of AF. Normal heart rhythm returns spontaneously in about half of all people after a brief, single episode of AF. But if you have recurrent or severe symptoms --or if age, general health or other pre-existing

                                            Treatment Options 
MEDICATIONS
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Anticoagulants/aspirin                             Reduce risk of a clot-caused stroke.
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 Beta-blockers                                           Slow heart rate and make rhythm regular.
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Calcium channel blockers                         Alternative to beta-blockers
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Anti-arrhythmics                                        Restore normal heart rhythm.
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Procedures
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 Electrical cardioversion                              External or internal shock to regulate heart.
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Catheter ablation                                          Destroys AV node; implants pacemaker.
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Maze procedure                                            Effective, but aggressive, surgery

LIFESTYLE CHANGES
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 Exercise & diet                                             Smart daily regiments promote heart health.
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Avoid  alcohol & caffeine                              Both can cause rhythm irregularities.

medical conditions (such as heart disease, high blood pressure, diabetes or heart valve problems) place you at high risk for more serious complications---treatment is definitely needed. The initial priority a stroke. The long-term goal of AF therapy is to restore and maintain your normal heart rate and rhythm --a process doctors call cardio-version.