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(September 1, 2010)  Atrial fibrillation is the most common type of heart rhythm irregularity or heart arrhythmia. September has been declared National Atrial Fibrillation Awareness Month to increase awareness of this serious heart problem.

“Normally, the heart beats with a strong, steady rhythm,” said Arash Karnama, D.O. “The heart pumps oxygen-enriched blood throughout the body and sends oxygen-depleted blood to the lungs in a never-ending cycle. A dual-chambered system allows one side of the heart to pump oxygen-rich blood while the other sends oxygen depleted blood through the pulmonary artery to the lungs. Blood enters the heart through the top chambers or atria. Electrical impulses in the heart trigger both atria to contract and force the blood into the lower chambers or ventricles of the heart. When the ventricles contract, blood leaves the heart to circulate through the body or regain oxygen from the lungs. When the electrical signals are out of sync, an irregular heart beat occurs.

“With atrial fibrillation or afib, erratic or extra electrical signals disrupt the normal timing and the heart beats too fast or just quivers. When the heart quivers instead of contracting rhythmically, the atria don’t empty completely and blood can pool in the chambers. This pooled blood is more likely to form blood clots. If the heart pumps a clot into the blood stream, it can circulate to the brain and cut off blood flow, causing a stroke. Rapid irregular heart beats can also overwork the heart and cause heart failure.

Often existing heart disease contributes to the development of atrial fibrillation. However, other risk factors include high blood pressure, heavy alcohol use, lung disease or a high thyroid level. Some prescription medications like albuterol (asthma inhaler) can cause afib. And, the use of stimulants such as caffeine, nicotine, decongestants and illegal drugs such as cocaine can impact the heart’s rhythm.

Symptoms of atrial fibrillation include:

• Feeling dizzy or lightheaded
• Feeling out of breath
• Feeling weak and tired
• A sensation that the heart is racing, pounding, fluttering or beating unevenly.
• Chest pain
• Fainting

The most common treatments for afib are medications and electrical cardioversion. Rhythm-control medicines help return the heart to its normal rhythm and keep it there. Rate-control medicines keep the heart from beating too fast during afib. Electrical cardioversion uses a low-voltage electrical shock to return the heart to a normal sinus rhythm. Often, people with afib will be put on blood thinning medications to help reduce the risks of blood clots and strokes. If medications and cardioversion aren’t successful, ablation may be recommended. During ablation, small areas of the heart that cause or maintain the irregular heart rhythm are destroyed.

Many of the lifestyle recommendations for afib are the same as those for other types of heart disease:

• Don’t smoke
• Eat a heart-healthy diet with plenty of fish, fruits, vegetables, high-fiber grains and beans.
• Exercise all – or at least most – days.
• Follow your health provider’s recommendations to control conditions such as high cholesterol, high blood pressure or diabetes.
• Identify ways to manage stress.
• Avoid caffeine, alcohol and stimulants.
• Get a flu shot every year.

“Men are more likely to develop a-fib, but women are more likely to die prematurely from it,” Dr. Karnama concluded. “As you age, the risk of afib increases. However, we now see a growing number of cases of a-fib at a younger age, starting in the early 50s or even the 40s or 30s. And, it’s not unheard of for someone in their 20s to have afib. Existing heart disease is the most important risk for afib, but it can happen to otherwise healthy people. For someone with no existing heart disease, often afib occurs during a time of high stress, fatigue, or when they’ve over-indulged in caffeine, alcohol or smoking.”