Atrial fibrillation is a condition where the atria of the heart beat irregularly, causing the atria’s ability to contract to be impaired. This results in a fast and irregular heartbeat, leading to significant adverse effects such as
- Formation of blood clots in the atria, and the irregular beating may cause clots to dislodge and block cerebral arteries leading to paralysis, or block coronary arteries causing sudden myocardial infarction.
- The ventricles beat faster and irregularly, causing palpitations.
- Sudden heart failure may occur, especially in patients with abnormal heart function.
Who is at risk of atrial fibrillation?
Atrial fibrillation is commonly found in the following groups:
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- People with cardiovascular diseases such as hypertension, ischemic heart disease, valvular stenosis/regurgitation, heart failure, cardiomyopathy, congenital heart disease, and post-cardiac surgery conditions.
- People affected by other systemic diseases and various factors such as old age (65 years and older), obesity, sleep apnea, diabetes, pulmonary embolism, chronic lung disease, hyperthyroidism, pericarditis, viral infections, and sepsis.
- Other groups with unknown causes
What are the symptoms of atrial fibrillation?
Most patients with atrial fibrillation (AF) have no symptoms but often visit doctors due to complications, especially paralysis in various parts of the body. Others come with the following symptoms:
- Unexplained cerebral ischemia
- Palpitations, rapid and irregular heartbeat
- Chest pain or tightness, difficulty breathing
- Easy fatigue, weakness
- Severe fatigue during exercise
- Fainting
Diagnosis of atrial fibrillation
Diagnosis of atrial fibrillation requires heart examination using three methods. The doctor will interpret and consider the results before diagnosis, including:
1. Electrocardiogram (EKG)
2. Cardiac exercise test using a treadmill or Exercise Stress Test (EST)
3. Cardiac function test using high-frequency echocardiography (Echo)
Since atrial fibrillation does not always occur continuously, Holter Monitor / Cardio scan may be used for continuous heart monitoring to improve diagnostic accuracy and clarity.
Treatment of atrial fibrillation
Treatment consists of 3 parts:
1. Anticoagulant medication for patients at risk to reduce the incidence of stroke or sudden coronary artery blockage.
2. Medication to control heart rate or rhythm to reduce symptoms caused by atrial fibrillation. If medication is ineffective, the doctor may consider radiofrequency catheter ablation (RFCA) using radio waves via catheter or cryoablation to block the triggering signals causing reentry circuits from the pulmonary veins connecting to the left atrium.
3. Management of comorbidities such as hypertension, diabetes, obesity, sleep apnea, smoking cessation, as well as dietary control and moderate exercise.
Heart abnormalities can be prevented by self-care such as quitting smoking, eating a healthy diet, exercising, undergoing basic health check-ups, and monitoring oneself. If experiencing easy fatigue or palpitations, one should promptly see a cardiologist to identify the true cause to prevent progression and receive timely treatment.
