Atrial fibrillation

Atrial fibrillation. A cardiac arrhythmia is an alteration in the normal heart rhythm known as sinus rhythm. It is the most frequent cardiac arrhythmia and most frequently affects the elderly population.

It is also associated with a series of complications (such as embolism or Heart Failure ) that means that the quality of life of patients can be greatly affected. It generates a large number of hospital emergencies.

Summary

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  • 1 Classification
  • 2 How is it produced?
  • 3 Symptoms
  • 4 Diagnosis
  • 5 Treatment
  • 6 Prevention
  • 7 Source

Classification

It can be classified according to its duration in newly diagnosed AF: the one that is detected for the first time, paroxysmal: it remits in less than 7 days, persistent: lasts more than 7 days and permanent: habitual heart rhythm.

How is it produced?

Under normal conditions the heart contracts rhythmically and synchronously. This contraction is the result of an electrical impulse that is generated in the atrium, reaches the ventricle, and results in a heartbeat. In an arrhythmia, an alteration of this mechanism occurs that leads to the heart not contracting regularly, generating a rhythm disorder.

In AF, the atrium contracts quickly and disorganized by multiple electrical impulses, without coordination, causing rapid and irregular contraction of the ventricles with ineffective ventricular filling. The irregular rhythm that occurs can be as fast as 160 to 180 beats per minute (bpm). In the absence of a coordinated atrio-ventricular contraction, the blood can pool in the atrium and, when stagnant, lead to thrombi that can cause embolisms when they exit the bloodstream driven by the heart. Thromboembolism is one of the main complications of AF.

The main causes of AF include diseases of the heart or cardiac diseases no. The former include: heart valve disease, coronary artery disease, and myocardium (heart muscle). Among noncardiac is hypertension, anemia, hyperthyroidism , decreased oxygen in blood pressure, use of certain drugs , drugs and alcohol.

Symptoms

AF episodes can be symptomatic or asymptomatic. In many cases it is asymptomatic and the symptoms that are detected are those of its complications such as a cerebral embolism or Heart Failure . The most frequent symptoms in AF include: palpitations, chest pain, dizziness and dyspnea, or a feeling of suffocation and tiredness.

Diagnosis

The basic and most effective diagnostic test to detect this type of arrhythmia is the electrocardiogram that allows recording the characteristic irregular heart rhythm of AF. Other complementary tests may be requested to determine the cause of the arrhythmia, such as:

  • Echocardiogram: an imaging test that visualizes the morphology and function of the heart .
  • Holter: 24-hour record of heart rate.
  • Cardiac catheterization: a diagnostic test that through the introduction of a catheter that reaches the heart, through which a contrast medium is injected, allows the vascular tree of the heart to be seen.
  • Electrophysiological study: it allows obtaining a map of the heart’s electrical conduction system, to find out the type of arrhythmia and its possible origin. Drugs can be administered to eliminate the arrhythmia or destroy the abnormal conduction pathways by electromagnetic waves.
  • Analytical and arterial blood gas to detect possible causes of arrhythmia such as anemia or lack of oxygen .

Treatment

Treatment is aimed at controlling rhythm and heart rate as well as the appearance of complications associated with this type of arrhythmia (thromboembolism).

  • Antiarrhythmic drugs allow treating and controlling a large part of arrhythmias. They are the main treatment option. There are numerous groups of drugs that act by different mechanisms, slowing down the heart rate and restoring the normal rhythm of the heart . They can be administered orally or intravenously and always under medical supervision and indication.
  • Cardioversion is a treatment used to restore sinus rhythm (normal rhythm) after applying an electric shock to the chest or using intravenous drugs. It is usually used in emergency situations when the patient has severe symptoms due to arrhythmia.
  • Radiofrequency ablation is a procedure that uses a catheter and a device to map the electrical conduction pathways of the heart. Using high-frequency electromagnetic waves, the conduction pathways responsible for the arrhythmia can be destroyed.
  • Treatments aimed at reducing the complications of this arrhythmia: anticoagulant drugs.

Prevention

  • Leading a healthy life, avoiding alcohol, tobacco, drugs and stress helps prevent heart disease . Once this arrhythmia is diagnosed, it is important to follow the treatment and medical advice to prevent its complications.

 

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