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Atrial fibrillation

In case of Atrial fibrillation the operation of sinus node, which secures the regular rhythm of the heart fails and an irregular electrical activity controls the heart contractions. As a consequence, the ventricles contract too quickly and irregularly.

Atrial Fibrillation without treatment can cause serious intergrowth, like cardial failure and stroke, which are the most serious outcomes. Stroke (you can learn more here) can develop as a result of a clot coming from the heart or embolism.  It may origin from the Left Atrium orAtrial Appendage. Atrial Fibrillation can multiple the risk of stroke by 4-5 times.

33, 5 million people suffer from Atrial fibrillation worldwide, which is 0,5 % of the whole world’s population. The chance for the development of Atrial Fibrillation is 2,3 % over the age of 40, while this goes up to 5,9 % over the age of 65. In 70% of the time people suffering from this disease are between the age of 65 and 85. Also, men are more susceptible to the disease.

Normal rhythm (left) Atrial fibrillation (right);

Factors which increase the chance of Atrial Fibrillation (you can learn more about heart diseases):

  • Hypertension
  • Coronary artery stenosis
  • Mitral valve disease early after heart operation
  • Congenital heart disorder
  • Pneumonia
  • Pulmonary cancer
  • Pulmonary embolism
  • Hyperthyreosis
  • Excessive alcohol consumption

Typical symptoms of Atrial Fibrillation:

  • Irregular and quick palpitation
  • Tiredness
  • Breathlessness
  • Dizziness
  • Pain in the chest

In certain cases, Atrial Fibrillation can be totally free of symptoms. In these cases the disease can only be diagnosed by a routine medical examination.

According to the European Heart Rhythm Association the seriousness of symptoms is separated into 4 stages.

 

Types of Atrial Fibrillation:

  1. Arrhythmia recognized promptly
  2. Permanent Atrial fibrillation: when arrhythmia lasts for a lifetime. In this case regular heart beat cannot be permanently re-established.
  3.  Recurring, 2 or 3 times
  • Paroxysmal Atrial Fibrillation: arrhythmia spontaneously ceases within 2-7 days.
  • Persistent Atrial fibrillation: lasts for more than 7 days.
  • Long persistent Atrial Fibrillation: Atrial Fibrillation lasts for more than a year.

 

Possible monitoring methods of Atrial fibrillation:

  • Physical monitoring
    If irregular beating is recognized by feeling the pulse it might be the sign of arrhythmia.
  • ECG (you can learn more here)
    This is the basic tool for detecting the arrhythmia. If there is Atrial fibrillation, the P-waves will not appear on the ECG curve, and the contractions will be irregular.
  • Echocardiography
    It can help to identify valvular heart disease, analyze pumping function. Thrombus is also detectable with it in the chambers of the heart.
  • Lab test
    Examines the function of thyroid, kidney and liver.
  • Holter ECG
    Electrodes are placed on the surface of the body to record the electrical potential of the heart. Such continuous monitoring may help to reveal arrhythmias.
  • Transesophageal echocardiogram
    This method is able to detect the presence of thrombus in the Left Atrial Appendage, which is a risk factor in the development of Atrial Fibrillation.

Treatment of Atrial Fibrillation

There are many ways of treatment for those who suffer from Atrial Fibrillation. During treatments the primary purpose is to decrease the thromboembolic risk by using anticoagulant. After that it has to be decided whether to attempt the re-establishment of the regular sinus rhythm or try to keep the heart frequency in check.
 

Treatments to restore heart frequency
 

Electrical cardioversion

In this case the regular rhythm is restored by electrical impulse by the means of electrodes. Electrodes are placed on the chest of the properly prepared patient under a short anesthesia.


Catheter ablation

In this process radio frequency energy is used to fracture the source of an irregular stimulus or block its spreading.


 

Prospects, prognosis

In the presence of Atrial fibrillation, mortality and the number of further complications increase. The latter ones are:

  •          stroke (you can learn more here)
  •          thromboembolism
  •          cardiac failure
  •          failure in the functioning of Left Ventricle
  •          the extent of load capacity fall.

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Széchenyi 2020