Atrial Fibrillation and Flutter

Atrial fibrillation and atrial flutter are irregular heart rhythms that occur when the upper chambers of your heart (the atria) beat too fast.

Atrial fibrillation can be sustained or can occur in bursts. It creates an irregular heart rhythm, but you may not necessarily have an irregular heart rate. When the rate of atrial fibrillation is over 100 bpm (beats per minute), it is called uncontrolled atrial fibrillation.

Atrial flutter, on the other hand, is characterized by a heart rate of 250-400 bpm (a normal heart rate is 60-100 bpm). Atrial flutter is more dangerous because of these rapid rates.

Many underlying conditions can be associated with these irregular heart rhythms. Conditions often associated with atrial fibrillation and flutter include COPD (chronic lung disease), heart valve disease, high blood pressure, coronary artery disease, and thyroid disorders.

Atrial fibrillation often occurs with chronic alcohol ingestion or drug use.

These heart rhythms can also run in families or can occur as a result of a birth defect.

The biggest risk factor for atrial fibrillation and flutter is if you have had a previous episode. Other medical conditions may place you at risk for atrial fibrillation and flutter as well. These include:

• cardiovascular disease and high blood pressure
• lung disease
• thyroid disease
• other abnormal heart rhythms

Other risk factors include:

• heavy alcohol use
• anesthesia
• eating disorders

The symptoms of atrial fibrillation and flutter will depend on how fast your heart is contracting and if there is an adequate amount of blood moving through your heart. If the rate is too fast, your heart is not operating effectively and you will experience more symptoms.

Symptoms may include:

• heart palpitations
• weakness
• chest pain

An EKG (electrocardiogram) is a test that can show the electrical activity of your heart. Both of these irregularities are easily seen on an EKG.

Treatment is designed to control your heart rate and, if possible, restore you to a normal heart rhythm. In some cases of atrial fibrillation the goal is only to keep the heart rate under 100 and prevent complications.

The biggest risk factor with atrial fibrillation and flutter is that blood clots may form in your heart and travel to other parts of your body. Atrial fibrillation is the leading cause of stroke because of the blood clots that can form with this heart rhythm. Many people with atrial fibrillation or flutter are given blood thinners to help prevent blood clots from forming.

Medications

The initial treatment is a medication to slow your heart rate. Some medications that do this are called calcium channel blockers and beta-blockers. Medications that may help restore your heart to a normal rhythm may also be prescribed. These drugs are called antiarrhythmics. You may be given anticoagulant drugs to take on a daily basis to prevent blood clots from forming because of the high risk of stroke from these conditions.

Cardioversion

Also called defibrillation, this treatment involves delivering an electrical shock to your heart in order to restore normal rhythm. This approach is more effective in stopping the irregular heart rate than antiarrhythmic drugs.

AV Node Ablation

This procedure involves destroying your AV (atrioventricular) node, the area of your heart where the abnormal rhythm originates. After AV node ablation, you may require a pacemaker in order to establish normal rhythm.

These abnormal heart rhythms are becoming more common, making it a growing health concern. Early recognition and treatment is important to prevent disability that can occur from a stroke. There are many cases that are successfully treated after one episode and the irregular rate never returns.

The ideal treatment approach has not been determined, but guidelines are in place to help improve function and quality of life if you have chronic atrial fibrillation or flutter.

Modifying lifestyle factors such as alcohol intake and tobacco use are the best way to prevent irregular heart rhythms if you are at risk. Managing any underlying conditions you may have such as lung disease or high blood pressure is important as well.

However, there are many cases of atrial fibrillation and flutter that have unknown causes which makes prevention difficult.