For a healthy person, the average heart beat will range between 60 and 100. But whenever there is a disruption in the production or progression of the heart’s electrical signal conduction, it causes abnormality in heart rhythms.
The human heart has an electrical system that controls the rhythm and rate of heart beats. Sinus node or Sinoatrial node, also known as the heart’s natural pacemaker sends electrical impulses to the heart chambers thereby making them contract to pump blood. Electrical signals from the sinus node reach atrioventricular node (AV node) and then spread through the ventricles causing them to contract and push blood around the body. This normal electrical pattern is termed as the sinus rhythm. However, when the electrical impulses are generated from any other part other than the sinus node or when the electrical impulses are following an erratic path, it causes the heart to beat abnormally. A heart condition characterised by irregular heart rate or rhythm is called a cardiac arrhythmia.
Atrial fibrillation (AF) or A-Fib is the most common type of arrhythmia that can be benign or life-threatening. It happens when there is a lack of synchronization between the contractions of the atria and ventricles. Turbulence of blood flow during AF episodes can lead to clot formation which increases the risk of stroke and heart failures. Some of the main atrial fibrillation symptoms include fatigue, dizziness, palpitations, chest pain and shortness of breath. Evaluating atrial fibrillation symptoms and assessing the underlying medical cause is important to devise the right treatment. Controlling the heart rate, restoring normal sinus rhythm and reducing the risks of stroke — these are the main objectives of A-Fib management.
Treatment options of atrial fibrillation include medications, catheter-based procedures and surgical procedures. Medications are prescribed for blood clot prevention, rate control and rhythm control. Beta blockers, calcium channel blockers and digoxin are used for heart rate control, whereas, sodium channel blockers and potassium channel blockers are used for heart rhythm control. Vitamin K antagonists are prescribed as the blood thinning medications to prevent blood clot formation. Warfarin is the most commonly used vitamin K antagonist, while other anticoagulant medications include dabigitran, rivaroxaban and apixaban. Cardiac ablation surgery is preferred for some AF patients to re-establish the normal heart rate, when the medications don’t prove effective. During the cardiac ablation surgery, the malfunctioning tissue is destroyed with powerful radiofrequency waves. Implantation of a pacemaker and open-heart maze procedures are the surgical options available for AF treatment. The right AF management strategy is determined after analyzing the severity and length of AF episodes.