Management of Atrial Fibrillation

The human heart is a muscular pump which beats as a result of electrical impulses produced by a special group of cells in the heart that have the ability to generate electrical activity on their own. Any abnormalities in the heart rate or rhythm can be considered to be a fault in the electrical conduction system of the heart. If the heart rate remains constantly slower (bradycardia) or faster (tachycardia) with irregular rhythm, then it may be a heart condition called arrhythmia. Diagnosis of arrhythmia involves collecting information about symptoms, evaluating medical history and a physical exam. Electrocardiogram, cardio monitoring and blood flow blood pressure measurements are some of the diagnostic tests, blood pressure and procedures performed to identify the underlying cause of abnormal heart rhythms.

Atrial fibrillation or A-fib (AF) is a type of arrhythmia that happens when the electrical signals are not only generated from sinus node, but are also generated from different places in and around the right atrium. When the atrioventricular node (AV node) – the electrical relay station between the upp and lower chambers of the heart-- is flooded with multiple erratic signals  it leads to twitching of atria and desynchronised contractions of heart chambers. There are mainly three types of atrial fibrillation - Paroxysmal Atrial Fibrillation, Persistent Atrial Fibrillation and Permanent Atrial Fibrillation. Whenever the A-fib lasts from a few seconds to about a week, it is termed as Paroxysmal Atrial Fibrillation and when the A-fib episode continues for more than seven days, the condition is called persistent atrial fibrillation. When the abnormal heart rhythm persists all the time, it is called permanent atrial fibrillation. Both the paroxysmal and persistent AF can progress to permanent AF over a period of time, which is why it is highly recommended to seek treatment as early as possible.  

AF episodes cause a disruption in the blood flow thereby increasing the likelihood of blood clot formation.  That is why risk of acute cardiovascular events and strokes are higher among people with atrial fibrillation. Treatment of Afib aims in cutting down the risk of blood clot formation and restoring the normal heart rhythm. Medical therapy using anticoagulants and electrical interventions are performed to treat this heart condition. Electro cardioversion, catheter ablation and surgical pocket maze are the standard procedures opted by the cardiologists to treat arrhythmias. In some cases, ablate and pace approach is recommended. During this procedure, the AV node is destroyed and an artificial pacemaker is placed in the surgical pocket of the chest to ensure a regular backup rhythm. Choosing between pharmacological treatment and ablation procedures always comes down to factors such as degree of AF episodes, cardio health and evaluation of surgical complications.