Download Atrial Fibrillation: Does Your Heart Flutter, Flop, or Fly

Atrial Fibrillation: Does Your Heart Flutter, Flop, or
Fly?
Three Duke experts explain the signs and dangers of atrial fibrillation
What keeps your heart beating, every second of every day, throughout your life?
Your pacemaker. (Yes, you have one.)
The sinus node, a group of cells near the upper right chamber in your heart, is your natural pacemaker. It creates
the electrical impulses that start every beat of your heart . . . with . . . nice . . . even . . . spaces . . . between . . .
each.
In some people, sometimes, that nice, even rhythm can go chaotic. Atrial fibrillation (AFib) occurs when the upper
chambers of the heart (the atria) beat fast and irregularly.
Running Mice, Flopping Fish
Duke AFib specialists Tristram Bahnson, MD, Patrick Hranitzky, MD, and Tim Donahue, MD,
have heard many colorful descriptions from patients of what AFib feels like: a mouse running
or a fish flopping in the chest, a fluttering or racing heart, a fullness in the throat.
Most people with AFib -- but not all -- will also have fatigue, chest pain, or dizziness.
“AFib is the most common of the abnormal heart rhythms,” says Bahnson, who is also director of the Duke Center
for Atrial Fibrillation. “Up to one in 10 people will have it.”
Anyone, at any age, can get AFib, says Hranitzky, but there is a strong correlation between getting older and
getting the disorder. “AFib in a young person is typically due to a genetic predisposition,” he says.
In the older population, over 65 years old, AFib is most likely caused by environmental factors. That is, the fibers in
the atria stiffen with age, leading to chaotic electrical activity.”
In addition to growing old, other culprits commonly associated with AFib include high blood pressure, heart valve
disease, thyroid problems, and sleep apnea. “As many as half of people with sleep apnea will get atrial fibrillation,”
says Bahnson.
Why Worry?
Some people with AFib will have extreme fatigue or exercise intolerance, and some will not.
Some will have frequent symptoms, and some will have only occasional flutters.
For this reason, some people may not realize they have the disorder. But even the occasional racing heart should be
reported to your doctor, says Hranitzky.
“Frequent symptoms may warrant an EKG [electrocardiogram],” he says. “If the symptoms are infrequent,
monitoring may not be necessary, but a consultation with your family doctor is needed.”
The most pressing danger of not getting AFib treated is stroke -- people who have AFib are at a much higher risk of
stroke than people who don’t.
But once the AFib is diagnosed, the stroke risk can be lessened with anticoagulants (blood thinners).
And there’s a second risk, says Donahue, who treats patients at Durham Regional Hospital. “When the heart races
for long periods of time, that can lead to heart failure, and this can happen in a matter of weeks.”
Heart failure occurs when the heart is damaged enough that it can’t adequately do its job of pumping blood through
the body.
Mastering the Rhythm
The first line of defense against AFib is usually medication.
“Normally we’ll prescribe benign medication like beta–blockers -- medications that slow the heart rate -- in addition
to aspirin or some form of blood thinner, such as warfarin [Coumadin] to reduce stroke risk,” says Hranitzky.
For many people, these medications will be enough to get rid of most, if not all,
symptoms and restore quality of life. For those who do not get relief, there are more options, including pacemakers
and, more recently, a minimally invasive surgical procedure called catheter ablation.
“Ablation is a game-changer,” says Donahue. “It allows us to cure AFib completely in some patients.”
In the procedure, long and flexible tubes (catheters) are inserted in the veins, usually in the groin, and are threaded
up to the heart through the blood vessels.
Instruments on the catheters are used to cauterize (burn) regions of the heart that are responsible for disrupting
the heart rhythm. The cauterizing creates scar tissue, which disrupts the electrical activity that causes the abnormal
rhythm.
Because the procedure is minimally invasive, complications from catheter ablation for AFib are rarely serious. But
it’s still an evolving procedure that is now offered at only a limited number of centers in North Carolina.
Duke physicians have documented some of the lowest complication rates for patients who undergo catheter ablation
compared with other centers in North Carolina and around the world.
Take Heart
The consensus among Duke experts is that virtually all AFib patients can be successfully
treated.
“But it’s very important to get treated early,” says Bahnson. “Successful therapy is
improved by early intervention. Plus, it is very important to have your stroke risk assessed
early.”
The Duke Center for Atrial Fibrillation
The Duke Center for AFib offers an unusual breadth of experience for patients.
In addition to a wide array of treatment options, the center recognizes the other conditions common among AFib
patients such as sleep apnea or heart failure, and collaborates with other Duke experts to treat them.
“Duke is unique in that our treatment strategies are varied, we have a large spectrum of treatment options, and we
recognize that it is important to individualize care,” says Bahnson.
Name: _____________________________________________
Questions
1. What keeps your heart beating, every second of every day, throughout your life?
______________________________
2. What is your sinus node? ________________________________________________________
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3. Atrial fibrillation occurs when ____________________________________________________
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4. What are the descriptions of what “AFib” feels like to patients? __________________________
____________________________________________________________________________
5. What is the reason why young people (like Mr. Houghton!) typically get AFib? _____________
____________________________________________________________________________
6. In addition to growing old, what are the other four culprits to causing Atrial Fibrillation?
____________________________________________________________________________
7. What does EKG stand for? _______________________________________________________
8. What is the most pressing danger of not getting AFib treated? ___________________________
9. What is another word for “blood thinners”? __________________________________________
10. Heart failure occurs when _______________________________________________________
____________________________________________________________________________
11. What are beta-blockers? ________________________________________________________
12. Summarize what happens during the ablation procedure: ______________________________
____________________________________________________________________________
____________________________________________________________________________
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13. What is successful therapy improved by? ___________________________________________
14. Mr. Houghton has atrial fibrillation. It has been recommended that if the medication he is on
does not work, he should get surgery on his heart. Do you feel this procedure would be a good
idea? Yes OR No, AND why?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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