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Atrial Fibrillation

What is Atrial Fibrillation (AF or AFIB)?

Atrial Fibrillation is a common heart disorder found in about 2 million Americans. The heart’s two small upper chambers (the atria) quiver,instead of beating effectively. In AF the atria beat out of rhythm with the rest of the heart. This generally causes the lower pumping chambers of the heart (ventricles) to beat rapidly and irregularly.

Who Gets AF?

About 4% of people over 60 years of age have AF and more than 9% of those over 80 years of age have AF. AF can occur in otherwise healthy individuals. In some cases,AF is associated with underlying structural heart disease or occasionally, with thyroid disorders. It often occurs in patients with chronic lung problems.

How Would You Suspect You Have AF?

Although, some patients with AF experience no symptoms, many experience a wide variety of symptoms, including:

  • Palpitations: A sudden pounding, fluttering, or racing sensation in your chest, which may feel like “butterflies”
  • Dizziness: Feeling light-headed, like you’re going to faint
  • Chest Pain: A highly variable sensation of discomfort, pressure, or pain in the chest
  • Fatigue and Shortness of Breath

How is AF Identified?

A routing EKG or heart monitor that you take home can diagnose AF

What Are the Risks of AF?

Even if your AF is barely noticeable, you must be aware of the possible dangers. Blood isn’t pumped completely out of the atria, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke result.

How is AF Treated?

  • Warfarin (Coumadin) and the newer drugs, (Xarelto, Pradaxa, Eliquis) is standard care to help thin the blood to prevent strokes.
  • Medications are used to slow down rapid heart rate associated with AF. These treatments may include drugs such as digoxin, beta blockers (atenolol, metroprolol, propranoiol). calcium channel blockers (verapamil & diltiazam), Propafenon, quindinine, and pronestyl.
  • Some patients require atrial antiarrhythmic treatment in an attempt to maintain normal rhythm.
  • Electrical cardioversion may be used to restore normal heart rhythm with an electric shock, when medication doesn’t improve symptoms.
  • Antiarrhythmic medication can be used and help keep the heart in a regular rhythm but these drugs are effective in 1/2 of the time and have side effects and toxicities.
  • Radiofrequency ablation may be effective in some patients when medications don’t work. In this procedure, thin and flexible tubes are introduced through a blood vessel and directed to the heart muscle. Then, a burst of radiofrequency energy is delivered to destroy tissue that triggers abnormal electrical signals or to block abnormal electrical pathways.
  • Surgery (rarely performed) can be used to disrupt electrical pathways that generate AF.

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