Atrial Fibrillation: Understanding Heart Rate and Pulse Discrepancy

Atrial fibrillation (AFib) is characterized by an irregular and often rapid heart rhythm. The concept of pulse rate being higher than heart rate in AFib is theoretically incorrect. In reality, the heart rate is typically higher than the pulse rate during AFib episodes. This discrepancy occurs due to ineffective contractions of the heart, which fail to generate a palpable pulse.

Treatment Strategies for Atrial Fibrillation

For patients diagnosed with AFib, the primary treatment goal is to restore and maintain a normal sinus rhythm. This process, known as cardioversion, can be achieved through medications or electrical interventions. Additionally, it is crucial to prevent thromboembolic events, particularly strokes, which are a significant risk in AFib patients.

Upstream Therapy and Risk Factor Management

Beyond acute treatment, managing underlying conditions that contribute to AFib is essential. For instance, patients with hypertension should focus on strict blood pressure control. Medications such as ACE inhibitors or ARBs can help reduce blood pressure while also decreasing the frequency of AFib episodes.

Chronic poor blood pressure control is a major contributor to atrial remodeling, where increased atrial pressure leads to structural changes in the heart. These changes can promote electrical instability, resulting in arrhythmias like AFib. Similarly, other conditions such as ischemic heart disease or valvular abnormalities can lead to atrial enlargement and subsequent rhythm disturbances.

Conclusion

Effective management of atrial fibrillation involves a comprehensive approach that includes rhythm control, stroke prevention, and addressing underlying causes. By focusing on both immediate and long-term treatment strategies, patients can significantly reduce their symptoms and improve overall heart health.