Atrial Fibrillation (AF) is a common arrhythmia, affecting about 2% of the population, that if not recognised and treated can lead to heart failure and stroke. Atrial Fibrillation occurs when there are abnormal electrical impulses in the atria. Uncontrolled impulses travel through the atria causing muscle fibres to contract out of sequence and “quiver” (fibrillate). This fibrillation prevents the heart from pumping normally so blood flow is affected and blood may pool in the atria leading to the formation of clots and the increased risk of stroke.
The symptoms may include palpitations, dizziness, weakness, and fatigue. One patient described the sensation of feeling their heart stop and a sensation of complete emptiness before the fibrillation sensation began.
There are also individuals who will experience no symptoms and their AF is only found when undertaking tests for another unrelated condition. Irrespective of symptoms AF should be treated to prevent heart failure and stroke.
Treatment of AF depends on the severity of the symptoms, the duration of each episode, the risk of stroke for each individual, and the risk associated with treatment options.
With an acute AF episode, it is important to get the heart back into a normal rhythm. A number of people will return to normal rhythm spontaneously – others will need assistance. Cardioversion can be physically applied – where an electric shock is administered under anaesthetic or pharmacologically with the administration of sotolol or amiodarone. Long term treatment includes a combination of beta-blockers and/or calcium channel blockers and anticoagulant therapy such as warfarin. Ablation – inactivating the area of tissue that is causing the impulse is usually only attempted when conservative management strategies fail.
The Heart Foundation has a great brochure to assist with patient education – click here>> to find out more.