Atrial fibrillation, also called AF or AFib, is a type of racing of the upper part of the heart (supraventricular tachycardia) caused by multiple abnormal electrical short circuits in the heart’s top left chamber (left atrium) just outside the pulmonary veins.
These abnormal electrical short circuits occur at a rate much faster than the sinus node rate, producing a heart rate of 100 or more beats per minute. Symptoms of atrial fibrillation may include heart palpitations (sensations of a racing heart), lightheadedness, chest tightness, shortness of breath and fainting.
Atrial fibrillation is primarily detected and diagnosed through a non-invasive electrocardiogram (also called EKG or ECG) that provides physicians an electrical tracing of your heart.
But not all patients are the same, and your atrial fibrillation may be paroxysmal, meaning that it only happens intermittently. In such cases, you’ll be asked to wear a heart monitor (also known as mobile telemetry or event monitor) that records your heart activity continuously. Through the heart monitor, the abnormal heart rhythms are tracked remotely and recorded to help your physician make a diagnosis.
Treatment may include:
- Antiarrhythmic medications that suppress the abnormal rhythm.
- Anticoagulation medication to reduce the risk of blood clots. Many patients with AF have an increased risk for stroke and other problems requiring blood-thinning medications.
Minimally invasive procedures
- Radiofrequency (RF) ablation for atrial fibrillation where a catheter emitting heat energy is advanced into the heart to cauterize the abnormal electrical circuit or focus. The procedure is performed in conjunction with an electrophysiology study (also known as an EP study or EPS).
- AV node ablation and pacemaker insertion, where the AV node is cauterized, disconnecting the electrical connections between the heart’s top and lower chambers. A heart pacemaker is implanted to set the heart rate of the bottom chambers to correct the heart arrhythmia.
- Left atrial appendage closure is the removal of the left atrial appendage from the left atrium with the goal of reducing the risk of stroke, while potentially eliminating the need for anticoagulation (blood thinning) medication.
- Maze procedure is an open heart surgical procedure to eliminate abnormal electrical circuits of AF. Because RF ablation has become more common, the Maze procedure is now mostly reserved for patients who already need open heart surgery for other reasons such as a valve repair or replacement, or coronary artery bypass graft.