Understand the symptoms and treatment options for an irregular heartbeat
Normally your heart beats about 60 to 80 times per minute and, thanks to a complex system of electrical surges, its rhythm remains steady. But atrial fibrillation (AF)—whose symptoms can include palpitations, chest pain (angina), shortness of breath and even fainting—occurs when the coordinated contractions of the heart’s upper chambers (the atria) are replaced by a quivering motion (fibrillation), which in turn causes irregular, often excessively rapid contractions in the lower chambers (the ventricles).
Coronary heart disease and high blood pressure are both risk factors for AF. Age is also a factor: 9 percent of those over 80 experience it. Learning the symptoms and treatment options can help demystify this disruptive and frightening condition.
1. Know the symptoms of atrial fibrillation.
If you experience palpitations, chest pain or shortness of breath, call your doctor or 911—the reduced output of blood can cause heart failure, but the greatest danger associated with AF is stroke.
2. Get treated for atrial fibrillation.
Medications such as beta blockers, calcium channel blockers and digoxin can control a rapid heart rate. A normal heart rhythm can often be restored with meds or the application of electrical shock to the heart (cardioversion).
3. Prevent stroke
If you experience AF, your doctor will likely prescribe aspirin, warfarin or dabigatran. These can help to minimize atrial fibrillation’s major risk—the potential for pooled, stagnant blood to form clots that travel to the brain and trigger stroke. In December 2012, the FDA approved apixaban (Eliquis) to reduce the risk of blood clots and stroke in people with atrial fibrillation that isn't caused by heart valve problems. This medication is not used in people who have undergone heart valve replacement or those with AF caused by a valve problem. The most serious risk associated with apixaban is bleeding.
By Simeon Margolis, M.D., Ph.D.
From our sister publication, Diabetes Focus (Winter 2011); Updated January 2, 2013