What Is Atrial Fibrillation?
Atrial fibrillation (also called AF or AFib) is the most common heart rhythm disorder in adults. It is caused by a variety of factors. AFib shows as abnormal electrical activity in the upper chambers (atria) of the heart. These extra signals make the atria beat very quickly and unevenly.
When the atria beat so fast and unevenly, it may quiver instead of contract (tighten). If your atria don’t contract, they move less blood to the bottom part of your heart (ventricle).
Atrial fibrillation is a serious condition because your heart needs to move blood through its chambers to keep your body healthy. If your heart can’t move blood the way it would normally, you will experience symptoms like chest pain and tiredness. AFib itself does not cause death (except in extreme circumstances).
Types of AFib
There are two types of atrial fibrillation:
- Paroxysmal atrial fibrillation
- Persistent atrial fibrillation
Can Atrial Fibrillation Come and Go?
Some people have atrial fibrillation that comes and goes (paroxysmal). They can be in normal rhythm one moment, and the next flip into AFib for minutes, hours, or even days. And some people don’t even notice this. Other people live with AFib 100 percent of the time, every day (persistent). More than two million people in the US have AFib.
Nonvalvular and Valvular Atrial Fibrillation
You may hear these terms on TV or from your clinician. Valvular AF means that it is due to a very specific heart valve problem. Nonvalvular means that the AF is not due to a specific heart valve problem (but there may be other, unrelated heart valve problems).
Is AFib Dangerous?
Having AFib usually isn’t immediately life-threatening. But people with AFib are more likely to develop other related heart problems.
If you’ve been diagnosed with AFib, you may have a higher chance of developing other dangerous conditions like stroke or heart failure—this is why it is important to see an AFib clinician, even if you don’t have symptoms.
Stroke
If you have AFib, the heart muscle doesn’t contract normally. When the heart muscle contracts, it forces open the heart valves and passes blood from the atrium to the ventricle. Blood that isn’t kept moving can pool and form clots in your atria.
These clots can move into other parts of your body and cause serious problems, such as a stroke. Importantly, patients with AFib have higher chances of having a stoke even when their heart is not in AFib.
Heart Failure
With atrial fibrillation, heart function may decrease, and can lead to symptoms of heart failure. Symptoms of heart failure also get worse over time.
With you we will determine a customized treatment plan for your unique situation, and adapt that plan over time, as your situation change and as our treatment for AFib evolves.
Why Choose University of Utah Health for AFib Treatment
Atrial Fibrillation Treatment Program
Experiencing heart pain, difficulty breathing, or other symptoms of atrial fibrillation can be alarming. We are here to provide you with the best specialized treatment.
Our experts bring many years’ experience and cutting-edge research to give you the best care possible. We also provide high-quality, coordinated care. We constantly conduct research looking for better treatments—AFib research is a rapidly-changing field, and we’re here to lead the way!
We know that many patients need personalized treatment options to meet their unique needs. We are here to partner with you for life offering exceptional care. With you we will determine a customized treatment plan for your unique situation, and adapt that plan over time, as your situation change and as our treatment for AFib evolves.
We aim to give you the best care that is right for you.
AFib Doctors Near You
AFib Symptoms
Common symptoms of AFib include:
- palpitations (a fluttering heartbeat),
- dizziness,
- weakness or tiredness,
- chest pain or tightness,
- shortness of breath, or
- exertional limitation.
Sometimes patients will have different symptoms.
AFib Causes
In many cases, doctors don’t know what causes atrial fibrillation. But certain risk factors may increase your chances of developing AFib. A risk factor is anything that increases your chances of developing a disease.
Possible risk factors include the following:
- Coronary artery disease
- High blood pressure
- Heart failure
- Valvular heart disease
- Inflammation of the heart muscle
- Inflammation of the heart lining
- Recent heart surgery
- Congenital heart defects
- Hyperactive thyroid
- Sleep apnea
- Lung disease
- Older age (AFib is more common in older people.)
- Diabetes
- High alcohol intake
- Drug abuse
AFib Treatment
There are several goals of AFib treatment:
- Address any conditions that are contributing to the cause of AFib (such as high blood pressure, diabetes, sleep apnea).
- Improve or eliminate symptoms of AFib and improve quality of life.
- Reduce the risk of other bad things happening due to the AFib (such as stroke, heart failure, and the like).
We can accomplish these goals through various treatments for AFib. They can:
- prevent blood clots from forming,
- control your heart rate, and
- reduce the amount of time heart is in AFib, compared with normal heart rhythm.
Treatments include:
- Lifestyle changes;
- Medications,
- Blood-thinning medications, such as warfarin
- Basic heart rhythm medications,
- Complex heart rhythm medications;
- Cardioversion, a procedure to 'reset' the heart into normal rhythm;
- Cardiac catheter ablation;
- Left atrial appendage closure; and
- MAZE procedure (or surgical ablation).
You may need to make some lifestyle changes to help manage your AFib. Too much weight, caffeine, tobacco, or alcohol can contribute to arrhythmias. Your physician may ask you to stop taking/using substances that may cause AFib.
AFib Medications
AFib medications can include blood-thinning medication and heart rate medications.
Blood-thinning medications—Blood thinning medications work by decreasing the chance of the blood forming clots, particularly those inside the heart.
All blood thinners increase your chances of bleeding, but we choose this treatment method as a way to prevent your changes of stroke. Your clinician will decide if the benefit of reducing stroke risk outweighs the risk of bleeding on a blood thinner.
However, not all blood thinners are created equal! Some types of blood thinners, such as aspirin and certain drugs used for heart stents, are not the best for preventing stroke related to AFib. It is important to talk with your clinician about which one(s) are right for you, if any.
Warfarin (Coumadin®) is a common blood thinning medication. However, if you are on Warfarin, we have to closely monitor you. There are newer medications that don't require us to monitor you as closely. These can include (Savaysa).
Basic heart rhythm medications—Medications can mainly control your heart rate, whether it is in AFib or normal rhythm. They do this by reducing the number of electrical signals transmitted from the top to the bottom of the heart. This may improve symptoms and reduce the chances of developing heart failure.
Cardioversion
Cardioversion resets your heart to make it beat normally again. It sends a perfectly timed electrical shock to your heart. This causes all your heart cells to contract at the same time.
All electrical activity in your heart stops for a brief moment. When your heart starts beating again, your heart rhythm returns back to normal.
While this procedure can correct the heart's rhythm, it doesn't prevent the arrhythmia from coming back. For some patients, AFib does not come back for many months, and for others, AFib is back before they wake up. It's like hitting the reset button on a phone or computer - the will work normally for a period of time, but it does not get rid of a virus or underlying problem.
Cardiac Catheter Ablation
In this procedure, doctors direct a catheter (a thin tube) through your blood vessels towards your heart. They place the catheter close to the area that has the abnormal activity and then heat (or cool) the tip of the catheter. This destroys the small area of abnormal heart tissue.
In general, catheter ablation is the most effective treatment we have for AFib, but very rarely cures AFib. Additional treatments, such as medications and treatment of risk factors (such as sleep apnea), are still extremely important.
Next Steps
If you have some symptoms or are worried about your heart, request an appointment with one of our AFib specialists by calling 801-585-7676.
Referral Information
To schedule an appointment, our schedulers typically request a referral letter. This is not always necessary however. We also screen to make sure you have had certain tests have been completed. We do this to minimize the steps you need to get treatment.
