Atrial fibrillation, or AFib, is the most common type of arrhythmia.A heart arrhythmia is an abnormal rate or rhythm in your heartbeat. This can mean your heartbeat is too slow, too fast, or has an irregular rhythm.
Most arrhythmias are harmless, and may not cause symptoms. Some types, however, can have serious consequences and require treatment. Dangerous arrhythmias may cause heart failure, stroke, or low blood flow that results in organ damage. Most people with arrhythmias, even serious ones with treatment, live normal and healthy lives.
Approximately four percent of the U.S. population has either intermittent or permanent Afib. In people over the age of 60, the incidence rises to about nine percent.
AFib is caused by abnormal electrical impulses in the atria, which are the upper chambers of the heart. The result is a rapid and irregular pumping of blood through the atria. These chambers fibrillate, or quiver, rapidly.
In some cases of AFib, the fibrillation of the atria causes the ventricles, the lower chambers of the heart, to beat too fast. This is called a rapid ventricular rate or response (RVR). If you have AFib with RVR you’ll experience symptoms, typically a rapid or fluttering heartbeat. RVR can be detected and confirmed by your doctor. It can cause serious complications and requires treatment.
When the ventricles beat too rapidly they don’t fill completely with blood from the atria. As a result, they cannot efficiently pump blood out to meet the needs of the body. This can ultimately lead to heart failure.
Heart failure as a result of AFib with RVR is most common in those who already have another type of heart disease. RVR can cause chest pains and make conditions like congestive heart failure worse.
It’s possible to have AFib without RVR. If you have AFib, but a normal ventricular response, you may not experience any symptoms. Some symptoms are possible if you have AFib without RVR. These can include shortness of breath, dizziness, fatigue, or instances of excessive sweating.
The only way to definitively diagnose AFib, as well as RVR, is to get an electrocardiogram (ECG). This is a diagnostic tool that records the electrical activity of your heart. AFib and RVR create distinctive patterns of waves on an ECG that doctors can use to confirm the presence of the arrhythmia.
An ECG can be performed in a doctor’s office, but a 24-hour recording of the heart can also be made using a Holter monitor. This gives a more complete picture of what the heart is doing.
Some people with AFib don’t need treatment. But the presence of RVR or other health conditions make the arrhythmia more serious. In these instances, treatment is necessary.
There are three goals of treating AFib with RVR: Control the RVR, reduce the risk of blood clots, and restore the overall rhythm of the heart.
Medications are typically the first step to control the ventricular rate. Beta blockers, calcium channel blockers, and digoxin are all used to slow the ventricular rate in patients with this condition.
For some people, medications may fail to restore a normal ventricular rate. In this case, an artificial pacemaker, an electronic device that regulates the beating of the heart, can be installed.
A normal lifestyle is possible for most people with AFib, even those with RVR. The greatest risk is the possibility of stroke, but by making healthy lifestyle choices and following doctor’s instructions, the risk can be decreased.
Treatments for AFib with RVR are usually successful, but the condition often returns. Talk to your doctor to learn about the prognosis for your specific condition.
In addition to damage to the heart from heart disease or high blood pressure, medications and other factors can cause paroxysmal AFib, including:
Symptoms of paroxysmal AFib include lightheadedness, weakness, pounding heart, and chest pain. However, further complications also may occur.
Stroke and embolism are the most serious. Blood pooling inside the heart can coagulate and form clots. Those clots can travel to the brain, causing a stroke. They can also lodge in the lungs, the gut, and other sensitive areas, blocking blood flow and starving tissue.
If AFib persists over a long period without treatment, the heart may no longer effectively push blood and oxygen throughout the body. This could potentially result in heart failure.