Atrial Fibrillation: Causes, Symptoms and Treatment
Atrial fibrillation is an arrhythmia that has reached epidemic proportions, with an estimated 5 million new patients appearing worldwide each year.
Initially, it usually occurs in episodes, meaning that the heart rate, while normal, changes and becomes arrhythmia. The patient feels this as fluttering that lasts from a few minutes to hours. This initial stage (paroxysmal atrial fibrillation) can last for years.
Then the arrhythmia progresses, the episodes become more frequent and longer, and often requires a visit to the emergency room or hospitalization in order to convert the arrhythmia (conversion means restoring the heart rate to normal). This second stage, where atrial fibrillation lasts more than 7 days or when admission for conversion is required, is called persistent atrial fibrillation.
During atrial fibrillation, blood pools in the heart, which increases the risk of blood clots forming and causing a stroke. This is why it is important to diagnose it early so that the patient can receive anticoagulant treatment.
Atrial fibrillation is not a simple arrhythmia, it is a disease that worsens over time and causes damage to the heart, namely scarring and sometimes even heart failure.
This disease is treated:
- With a series of lifestyle changes (weight loss, alcohol restriction, proper nutrition, treatment of insomnia and anxiety), regulation of hypertension and diabetes mellitus if present, diagnosis and treatment of sleep apnea.
- With medications that limit episodes of atrial fibrillation, or that make atrial fibrillation better tolerated by reducing the heart rate during episodes.
- With medications that thin the blood (anticoagulants) to prevent stroke.
- With ablation of atrial fibrillation, i.e. an operation that is performed percutaneously (catheters are inserted into the heart through a central vein, without incisions). Ablation halts the progression of the disease much more effectively than medications and if done in the early stages of the disease can completely cure the arrhythmia. If done at a more advanced stage when atrial fibrillation has become persistent or has created a lot of scarring in the heart, it may not completely eliminate the arrhythmia, but it may improve symptoms and quality of life, and even survival in some cases.
Early diagnosis and informing the patient about all treatment options (including ablation) in the early stages of the disease, is the best way to design an individualized plan aimed at the optimal treatment of atrial fibrillation.
