What That Irregular Heartbeat Means
Posted 9/20/2017 by UHBlog
You know that feeling when your heart goes all aflutter? It’s wonderful if it happens occasionally when that certain someone enters the room. But for folks with regular occurrences of atrial fibrillation, commonly known as AFib, a quivering heart could be a warning sign for stroke.
“When you don’t have AFib, there’s well-organized activity of the upper chambers of the heart (atria),” says cardiologist Sergio Thal, MD. “With AFib, the electrical activity becomes disorganized. Instead of contracting, the atria are quivering. That affects blood flow through the heart and causes a risk of clotting – and one of these clots may cause stroke.”
There is no singular cause of AFib, but a combination of factors increases the risk of developing it. Some factors are modifiable (put out that cigarette!), and some are not (a forest of candles on your birthday cake).
According to Dr. Thal, 10 risk factors that can cause AFib are:
- Age – Risk increases as patients mature.
- Size – A bigger atria means a bigger risk of developing AFib.
- High blood pressure
- Sleep apnea
- Family history – There isn’t an AFib gene, but epidemiologists believe patients whose parents had or have AFib may be at a greater chance of developing it.
- Alcohol – Excessive drinking can trigger an episode of AFib.
- Hyperthyroidism – “You have an excited situation, and it increases your metabolism and heart rate,” Dr. Thal says.
- Young endurance athletes – This is rare.
The first step in managing AFib is to prevent complications of the condition, so your doctor will probably prescribe a blood thinner, such as Coumadin or a novel oral anticoagulant.
“They decrease the ability of the blood to clot, which prevents clots from forming on the heart,” Dr. Thal says. “The anticoagulation prevents the risk of stroke, but it does not prevent AFib.”
Your doctor will also treat AFib itself, when feasible. If you have permanent AFib, it may be determined, for various reasons, that you are not a candidate for attempting to bring your heart rate back to normal sinus rhythm. The heart beat's electrical impulse originates in the sinoatrial (sinus) node. Sinus rhythm is one attribute necessary for normal electrical activity in the heart. Instead, your doctor may prescribe medication to prevent your heart from racing, but you will remain in AFib.
However, if you have paroxysmal or persistent AFib – meaning you move in and out of AFib – there are means to attempt to bring your heart rate under control. These include:
- Medications that stabilize the upper chambers of the heart
- Electrical cardioversion, which uses electrical shocks to stop AFib and restore normal sinus rhythm
- Ablation, sometimes called pulmonary vein isolation, a procedure in which catheters are positioned from the groin to the veins in the heart to target the source of the arrhythmia
“It’s important for people to know that AFib can be treated and that achieving normal heart rhythm is very important,” Dr. Thal says. “AFib causes mortality from heart failure and stroke, so it is not a benign arrhythmia. Medications and ablations have come a long way, and we have a good success rate with patients.”
Sergio Thal, MD, is a cardiologist at UH Cleveland Medical Center, UH Ahuja Medical Center, and UH Chagrin Highlands, Euclid and Twinsburg health centers. You can request an appointment with Dr. Thal or any other doctor online.