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Dr Susanna Kent - Atrial Fibrillation - 19 August


Atrial fibrillation is a condition that can strike the young and fit as well as older people who are not so fit. It affects about 1% of people and 5% over the age of 80 years.

What is it?
It is a condition of the heart and involves the heart beating fast and irregularly. The abnormal rhythm is because of abnormal electrical impulses in the heart.

In a normal heart the electrical impulse comes from an area in the atrium (the top chamber). As the electrical impulse travels through the atrial chamber it produces a wave of muscle contractions and this causes the atrium to contract and squeeze blood into the lower chamber (ventricle). The electrical impulse then travels down through the lower chambers and causes them to contract, which completes a single heart beat.

In atrial fibrillation lots of impulses travel through the atria at the same time.
This causes irregular, fast and uncoordinated contractions of the atrial chamber. Also the ventricles (lower chambers) beat irregularly as well.

Symptoms
These are palpitations, shortness of breath and fatigue.

Causes
Often can occur without underlying heart disease, especially in young people.  Some of the causes are overactive thyroid, alcohol (holiday heart) blood clot in the lungs.
Other causes are heart valve disease, high blood pressure, coronary artery disease, malfunction of the SA node in the atrium.

Diagnosis
Via ECG i.e: a recording of your heart.

Treatment
There are 3 goals to treatment

  1. control ie: slow the rate of the heart  (decreases strain on the heart)
  2. restore the normal rhythm  (especially in the young)
  3. prevent stroke - with atrial fibrillation you are more likely to form a clot in the heart which can break off and go into your brain causing a stroke.

Treatment

  1. Drugs  (drugs to slow the heart and make the blood thinner and less likely to clot)
  2. Cardioversion. This involves giving an electrical shock to the heart to try and put it back into a normal rhythm.

Prevention
If  you do not have atrial fibrillation, then the best way to lower your chances of getting it is by being kind to your heart:

  • Don't smoke
  • Keep a healthy weight
  • Exercise regularly every day
  • Eat nutritious food
  • Get your blood pressure and cholesterol checked.
  • Use alcohol in moderation or not at all. Avoid use of stimulants (the odd coffee is ok!)

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