Atrial Fibrillation: What It Means And How To Treat It

Atrial fibrillation, commonly referred to as AFib, is a type of irregular heartbeat caused by disorganized electrical signals in the heart's upper chambers (atria). Instead of the normal sinus rhythm, the atria experience chaotic electrical activity that can occur at a rate of 400 to 600 beats per minute. However, not all of these signals reach the lower chambers (ventricles), as the atrioventricular (AV) node filters most of them out. Typically, only more than 100 beats per minute reach the ventricles, resulting in a heartbeat that is often irregular, inconsistent in strength, and variable in frequency. AFib often presents with a heart rate between 120 and 150 beats per minute.

Understanding Atrial Fibrillation

Atrial fibrillation is one of the most common types of arrhythmias, especially among older adults. It frequently occurs in individuals with underlying heart conditions such as coronary artery disease, hypertension-induced heart damage, heart valve disorders, and cardiomyopathy. This condition can significantly affect quality of life and increase the risk of complications like stroke if left untreated.

Treatment Options For Atrial Fibrillation

Managing atrial fibrillation involves a multi-pronged approach tailored to the patient's symptoms, overall health, and risk factors. The primary goals of treatment are to control heart rate, restore normal rhythm, and prevent blood clots that could lead to stroke.

1. Heart Rate Control

One of the key strategies in managing AFib is controlling the heart rate, ideally keeping it below 110 beats per minute. This is typically achieved through medications such as beta-blockers or calcium channel blockers. Alongside rate control, anticoagulant therapy is crucial to prevent blood clots. Traditional medications like warfarin or newer oral anticoagulants (NOACs) are commonly prescribed for this purpose.

2. Rhythm Restoration

Another treatment approach involves restoring the heart's normal rhythm as soon as possible after an AFib episode begins. This can be done using antiarrhythmic drugs or through a procedure called cardioversion, where an electrical shock is delivered to reset the heart's rhythm. Prompt rhythm control can help reduce symptoms and improve heart function.

3. Minimally Invasive Procedures

For patients who do not respond well to medications or experience recurrent AFib episodes, a procedure known as catheter ablation may be recommended. This involves using radiofrequency energy to target and destroy the specific areas of heart tissue responsible for the abnormal electrical signals. In some cases, this can offer long-term relief and significantly reduce the need for ongoing medication.