What is Atrial Fibrillation

This is a question I often hear when talking to members of the parish and community. The frequency of the question is understandable as Atrial Fibrillation, typically abbreviated AFib, is one of the most common cardiac conditions, affecting 2.7 million Americans. AFib is an irregular heartbeat of the top chambers of the heart, known as the atria. It is best described as a quivering of the atria. This quivering can be rapid or slow and changes the way the blood flows through the heart. This change in blood flow can cause blood clots to form in the heart. Blood clots from AFib can then leave the heart and travel to the brain causing a stroke. In fact, people with AFib have a 5-fold increased risk of stroke.

The most common symptom of AFib is a rapid and irregular heartbeat. People will often say it feels like their heart is skipping beats or is pounding against their chest. Other symptoms include fatigue (especially with exercise), nausea, dizziness, and pressure in the chest. An interesting aspect of AFib is that it will most often come and go. You may have an episode that lasts just minutes or maybe a few hours only to then feel fine and not have another episode for weeks or months. This irregular nature often leads people to a false sense of security that what they experienced was just a temporary event and they fail to talk to their doctor about it. However, every episode increases the risk of blood clot formation in the heart. Many episodes are also asymptomatic so you could be having AFib without realizing it. Many patients aren’t diagnosed until they have a workup by their doctor for unrelated issues.

If you think you are experiencing or could have experienced AFib, the most important thing is to talk to you doctor. There are several different medication types that can be used to help stop, control and/or prevent AFib. Which one is best for you will vary and is best left to your primary care doctor or cardiologist. You may also be asked to start taking an antiplatelet like aspirin or a blood thinner like warfarin (Coumadin®), apixaban (Eliquis®), rivaroxaban (Xarelto®), edoxaban (Savaysa®) or dabigatran (Pradaxa®). These drugs help prevent the formation of blood clots and can significantly reduce your risk of stroke from AFib. Which product is best for you will vary and should be discussed with your doctor or pharmacist.

The most important take home point is that if you feel something abnormal you need to seek help immediately. Symptoms like chest pressure or a racing heartbeat are a medical emergency and you should call 911 or get to a doctor immediately. Even if you just feel more tired at times or feel your heart skipping some beats you should tell your doctor right away. AFib can be managed but it must be caught first. Just this week I had a patient in the ICU at Borgess that came in with a stroke from AFib. You do not want that to be your impetuous for diagnosis. More detailed information can be found at http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp#.WSS_32grKUk or by talking with your doctor or pharmacist.

Justin Rak


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