ATRIAL FIBRILLATION: THE FACTS

 

Those associated with Fortwilliam Golf Club will be aware that over the past number of years the club has supported the efforts of a few of its members in the promotion of Atrial Fibrillation [AF] awareness. This promotion was aimed at informing members of the potential dangers of being affected by the condition including the increased chances of suffering a stroke or heart failure. It was also designed to remind members that it can affect adults of any age, but is more common as people get older.

This information bulletin will explore a number of the issues associated with AF, including what it is, its causes, the symptoms, the risks and the treatment. The bulletin has been endorsed by a leading cardiologist.

 

WHAT IS AF?

AF occurs when chaotic electrical activity develops in the upper chambers of the heart or atria. As a result the atria no longer beat in an organised way and pump less effectively. This may lead to symptoms of palpitations, shortness of breath, chest discomfort, light headedness, fainting or fatigue. The goal of the treatment in AF is to restore the heart’s normal rhythm and if this is not possible then to slow the irregular heart rate, to alleviate symptoms and prevent complications related to stroke and heart failure.

 

WHAT ARE THE CAUSES?

AF is related to age; the older you get the more likely you are to develop it. Men and women are equally susceptible. Below are several conditions associated with AF;

·        High blood pressure

·        Coronary heart disease

·        Congenital heart disease [abnormality of the heart present since birth]

·        Pneumonia

·        Lung cancer

·        Overactive thyroid

·        Carbon monoxide poisoning

In addition, alcohol and drug abuse may predispose you to AF. While your risk of AF goes up with the problems mentioned above, many people develop AF for no apparent reason.

 

WHAT ARE THE SYMPTOMS?

Symptoms of AF include:

·        Palpitations which may be rapid

·        Tiredness

·        Shortness of breath

·        Dizziness

·         Chest pain

 

Some people with AF do not have any symptoms and it may only be discovered at a medical examination. A simple method of detection is to feel your pulse for an irregular beat.

 

WHAT ARE THE RISKS OF AF

The main risk associated with AF is stroke. This occurs because the atria are fibrillating and not beating in a co-ordinated way. As a result, the blood in the atria can become stagnant causing blood cells to stick together and form a clot which can travel to the brain and result in a stroke.

Having an uncontrolled [high] heart rate for long periods can damage the heart. In extreme cases, often when the rate is very fast or when it happens in a damaged heart, AF can cause heart failure. In general, however, AF is not considered a life threatening condition as long as it is treated appropriately.  

 

ARE THERE DIFFERENT TYPES OF AF

Yes, early in the disease AF is often intermittent meaning that it can come and go without warning and there may be long periods of time between “spells”. When AF first occurs, the early episodes may be brief and cause very mild symptoms. In fact, some people with this early stage AF may not even know they have it. AF falls into one of three categories that describe the progression of the disease, ranging from occasional episodes to the complete absence of a normal heart rhythm;

1.     Paroxysmal AF – multiple episodes that cease within 7 days without treatment

2.     Persistent AF – episodes lasting longer than 7 days, or less than 7 days when treated.

3.     Permanent AF – when the presence of AF is accepted by the patient and he physician and strategies to restore rhythm are not being pursued.

 

HOW CAN I GET THE APPROPRIATE TREATMENT?

Initially your GP may arrange some investigations if consulted. Depending on the results of these investigations, you may be referred to a relevant cardiologist to determine an appropriate diagnosis. Following diagnosis, some patients will respond to medication and in such cases it may be that no further treatment will be required. In other cases, however, more complex solutions may be necessary. These can include, for example, surgery to perform a catheter ablation;  a treatment which destroys small areas inside the heart causing the AF or a cardioversion which uses an electrical shock to revert the heart back to a normal rhythm.

 

MOST IMPORTANTLY, IF YOU THINK ANY OF THE ISSUES DISCUSSED IN THIS BULLETIN RELATE TO YOU OR A MEMBER OF YOUR FAMILY OR IF YOU ARE UNSURE, PLEASE ARRANGE TO SEE YOUR GP IMMEDIATELY