Questions and Answers: A Look at Atrial Fibrillation

 
Gene C. Kim, MD
Cardiology, Electrophysiology

The normal heart beats 60 to 100 times per minute regularly. The SA node is the heart’s electrical pacemaker that initiates the electrical impulse and determines the rate at which the heart beats. There are times when the heart may beat more slowly or quickly. There are other times the heart beats irregularly or rapidly due to atrial fibrillation.

 
Q: What is atrial fibrillation?

A: It is the most common type of abnormal heart rhythm in the United States affecting over 2 million people. It results in quivering, ineffective and uncoordinated contraction of the atria (upper heart chambers) at > 300 beats a minute instead of regular synchronized contractions at 60 to 100 beats per minute. The uncoordinated contractions and electrical signals are transmitted to the ventricles (lower heart chambers) in an irregular fashion usually at rapid rates. This leads to the irregular heart beats and pulse.

Q: What causes atrial fibrillation?

A: Unfortunately it has not been clearly determined. There are multiple conditions that are associated with atrial fibrillation. Some of these conditions are sinus node disease, coronary artery disease, previous heart attack, heart failure, rheumatic heart disease, pericarditis, hypertension, hyperthyroidism, binge drinking of alcohol, pulmonary embolism, sleep apnea, drug use and many other diseases.

Q: What symptoms would I experience if I have atrial fibrillation?

A: There are many patients that may be asymptomatic and are told on routine physical that they have a rhythm problem. Others may complain about palpitations (sensation of rapid heart beats), fatigue, weakness, shortness of breath, chest pain, light-headedness, and fainting.

Q: How is it diagnosed?

A: Atrial fibrillation can often be diagnosed by your primary care physician with a physical examination. Using a stethoscope, an irregular heart rhythm may be heard or the pulse can be checked for irregularity. Besides physical examination, an electrocardiogram (ECG) can easily provide the diagnosis of atrial fibrillation if present at the time of recording. In some patients with intermittent, paroxysmal atrial fibrillation, the ECG may be normal during the office or hospital visits. A Holter monitor, 24 continuous heart rhythm monitor, or an event monitor, a patient activated device at time of palpitations, may be able to document the atrial fibrillation.   Continue »

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