Treatment for atrial fibrillation

Originally Published: February 28, 2014
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Dear Alice,

How do u treat afib......

Dear Reader,

Atrial fibrillation (afib, AF) is a common type of arrhythmia, or irregular heartbeat. Although AF may seem scary, take heart! There are a number of medical treatments and lifestyle choices that can help minimize the risk of afib, or even prevent it altogether. But first, to answer your question, there are several ways to treat afib and keep your heart from skipping a beat:

  • Lifestyle changes. Eating heart healthy foods, reducing your salt intake, avoiding stimulants such as nicotine and caffeine, exercising regularly, getting enough sleep, and limiting your alcohol consumption may all lower your risk for afib. Since this condition is most often seen in people 50 years and older, these lifestyle choices are at the heart of AF prevention among younger people.
  • Cardioversion, or resetting your heart’s rhythm. This procedure can be done in a hospital by administering anti-arrhythmic medications or by delivering an electrical shock while you are sedated. After cardioversion with drugs, you may have to continue taking an anti-arrhythmic agent to prevent further atrial fibrillation.
  • Reducing your heart rate. Different medications, such as digoxin, calcium channel or beta blockers, blood pressure lowering agents, or ACE inhibitors, can be prescribed to slow your heart rate. Rate control can also be done by more invasive procedures in which doctors use a catheter or open-heart surgery to scar the small areas of your heart tissue that send irregular electrical signals. Sometimes, a pacemaker is inserted after these procedures to help regulate your heart beat.

For those of you who aren’t familiar with afib, it occurs when the upper two chambers of the heart (the atria) beat quickly and chaotically, or “fibrillate.” The abnormal electrical signals that cause this fibrillation start in the atria and then travel to the lower two chambers of the heart (the ventricles), where they make the ventricles beat at rates from 100 to 175 times per minute, compared to a normal rate of 60 to 100 beats per minute.

Risk factors for afib include various heart conditions, binge drinking, sleep apnea, and possibly caffeine consumption. People with this condition may have symptoms such as heart palpitations, low blood pressure, chest pain, fatigue, dizziness, and more. During AF, the rapid and out of sync action of the atria and ventricles can also cause pooling of blood in the atria, formation of blood clots, inefficient delivery of blood and oxygen to the body and brain, stroke, or even heart failure.

If you think you may have this condition and need treatment, a healthcare provider can do some tests to determine if you have AF or another type of arrhythmia. These tests may include an electrocardiogram (ECG) or echocardiogram to monitor your heart function, a Holter monitor or event recorder to get a longer-term measure of your heart activity, blood tests, or a chest x-ray. Columbia students can contact Medical Services (Morningside) or Student Health (CUMC) to make an appointment. Once you have confirmed AF, you and your healthcare provider can decide on a course of treatment based on how long you have been having episodes of afib, any underlying conditions you may have, and what medications you can or can’t take.

Wishing you good health!

Alice