When the heart’s electrical conduction follows an abnormal pathway causing the heart to have an irregular beat or rhythm, it is called an arrhythmia. Atrial fibrillation is one of the most common heart arrhythmias. During a normal heart rhythm, the top two chambers contract together, forcing all of the blood into the ventricles. The ventricles then contract together pushing the blood out to the body and the lungs. In atrial fibrillation, the two small upper chambers of the heart – called the atria – beat in a fast, irregular, chaotic way. Often this is characterized as ‘quivering’ in contrast to the normal, forceful contraction. When this occurs, blood isn’t pumped completely out of the atria which may cause the blood flow to stagnate and pool, potentially allowing clots to form. This increases the chance of stroke because a clot in the atria can leave the heart and become lodged in an artery or the brain. At least 15 percent of strokes occur in people who have atrial fibrillation.
The severity of symptoms patients experience during atrial fibrillation spans a very wide range. Often, patients with atrial fibrillation have no symptoms from the condition and it is generally not life-threatening. It may, however, result in palpitations or rapid thumping inside the chest, fainting, chest pain or pressure or congestive heart failure. Additional symptoms may include:
There are several approaches to treat and prevent atrial fibrillation. Medications may be used to slow down the rapid heart beat or restore the heart’s normal rhythm. In some cases, medications are used to restore the heart’s normal beat and to help maintain a normal rhythm. Additional medications may be prescribed to reduce the risk of stroke and include aspirin-therapy or warfarin, an anticoagulant.
Electrical cardioversion, a non-invasive procedure using electrical or chemical stimulation to restore normal heart beat, may be used to convert an irregular heart beat to a normal rhythm.
When medications are not effective, additional procedures including radiofrequency ablation, or implanted pacemakers may be used to help regulate the heart rhythm, and are usually performed by an electrophysiologist. Ablation therapy is when small catheters are inserted through your veins to the inside of your heart. The electrophysiologist positions these catheters and ablates, or burns, a small area of heart tissue that is causing the irregular rhythm. This often causes the heart’s electrical current to go back to the normal conduction pathway therefore causing the heart to return to a normal rhythm.
Electrophysiology care is considered an advanced subspecialty of cardiac care, most often available in major cities and at academic medical centers. We offer these services right here in Kitsap County. The lab in our Heart & Vascular Center is specifically dedicated to patients needing electrophysiology procedures and treatments.