What is Atrial Fibrillation?
Atrial fibrillation (AF) is a heart condition characterised by an irregular and rapid heartbeat that hampers blood supply to the body. In atrial fibrillation, the upper chambers (atria) and the lower chambers (ventricles) of the heart lack coordination, causing a rapid and irregular heart rhythm. People with atrial fibrillation may experience palpitations, shortness of breath, and fatigue or lack of energy. Atrial fibrillation can be intermittent (occasional) or chronic. Atrial fibrillation is a serious medical condition that requires immediate treatment. If left untreated, it can lead to serious health consequences.
Risks Factors for Atrial Fibrillation
Some of the risk factors for atrial fibrillation include the following:
- Aging: Over age 60 although it may occur at any age
- Affects more whites than blacks
- Affects more men than women
- Uncontrolled hypertension (high blood pressure)
- Chronic lung disease
- Pulmonary embolism: blood clot in the lungs
- Nerve conditions
- Excessive alcohol, caffeine or tobacco intake
- Heart disease caused by high cholesterol
Diagnosis of Atrial Fibrillation
A cardiologist should evaluate all heart conditions for proper diagnosis and treatment. Your cardiologist will review your medical history and perform a thorough physical examination. Diagnostic studies may include routine blood tests, electrocardiogram (measures the electrical activity of the heart), chest X-ray, echocardiogram (ultrasound images) and Holter monitor (ambulatory device that measures the electrical activity of the heart).
Treatment of Atrial Fibrillation
Treatment options may include medications, specific medical procedures and surgery. Surgery may be necessary in patients with chronic AF who do not respond to medication or procedures and in people with other co-morbid conditions requiring a heart surgery. Surgical procedures for atrial fibrillation are open-heart procedures, performed under general anaesthesia.
- Maze procedure: In this procedure, several precise incisions are made in the upper chambers of your heart (atria) to confine the transmission of electrical impulses to a controlled path.
- Surgical pulmonary vein isolation: It is a modified Maze procedure during which alternative energy sources such as radio frequency, cryothermy, microwave or laser are used to create the lesions for scar tissue formation. This scar tissue blocks the abnormal electrical impulses and promotes conduction of impulses through a controlled path. These approaches can be performed through minimally invasive surgical techniques.
- Radio frequency ablation: This technique uses radio frequency energy to heat the heart tissue and create lesions similar to the lesions of the Maze procedure to block the abnormal electrical signals.
- Cryothermy: Cryothermy, also called cryoablation, is a technique that uses extreme cold temperature through an instrument called a cryoprobe, to produce lesions over the heart.
- Microwave technology: In this technique, microwave energy through a special wand-like catheter is used to produce several lesions over the heart to block the abnormal electrical impulses and to restore a normal heart beat.
- Laser technology: Lasers are also used to produce lesions over the heart. This approach offers great promise for the development of less invasive procedures.
In AF patients with other heart problems such as valve disease or coronary artery disease, which also require a surgery, a combination of surgeries may be used to treat AF and the co-morbid condition simultaneously.