If you are feeling a heaviness in your chest and experiencing a rapid heartbeat, light headedness and dizzy, you may be suffering from atrial fibrillation, the most common type of cardiac arrhythmia – or irregular heart beat.
There are several treatment choices, but the diagnosis must be made first.
Diagnosis
After taking your medical history, the doctor will conduct a physical examination and most likely order several tests to find an answer for your symptoms. Among the tests you can expect are:
Blood tests. Your doctor will want to check your thyroid hormone levels and electrolyte levels.
Chest X-ray. This will tell the doctor if your heart is enlarged.
Echocardiogram. This test uses sound waves to create detailed images of your heart – its size, structure and motion. Or the doctor may order a trans-esophageal echocardiogram, in which a flexible tube with a probe is inserted in your esophagus to capture detailed images of the heart.
Electrocardiogram. With this test, a technician will place electrodes on your body to measure the electrical impulses given off by your heart. This test measures the timing and rhythm of each electrical phase in the heartbeat.
Event recorder. This test utilizes a portable electrocardiogram device. When you experience an unusual symptom, you activate the device to capture the symptom.
Holter monitor. This portable electrocardiogram device is worn for at least a day to record the heart’s electrical activity as you go about your daily routine.
Stress test. This test requires you to walk on a treadmill or ride a stationary bicycle while you are hooked up to an electrocardiogram.
Treatment
Once the proper diagnosis of atrial fibrillation has been made, your doctor can consider the proper treatment. The goal of treatment is to restore your heart to a normal rhythm, which regulates your heart rate and helps to prevent blood clots. The course of treatment may include:
Cardioversion. This involves the doctor using paddles or patches on your chest to electrically shock your heart, which helps to restore the heart’s normal rhythm. Medication can also be used to stop a fast rhythm and restore a normal rhythm.
Catheter radiofrequency ablation. With this treatment, the doctor inserts thin, flexible catheters (tubes) into a vein in your arm or groin and threads the tubes through your blood vessels to your heart. The doctor then applies heat, which is actually radiofrequency energy, through the catheter to destroy the heart tissue that is causing the problem.
Atrioventricular node ablation. In this procedure, doctors use radiofrequency energy to destroy the electrical connection (AV node) between the upper and lower heart chambers, which blocks the heart’s electrical impulses. Once the AV node is destroyed, you will need a pacemaker implanted to establish a normal heart rhythm.
Medications. You may be able to take medications to control your heart rate or heart rhythm, or to prevent blood clots. Beta blockers, especially cardioselective beta blockers such as metoprolol, atenolol and bisoprolol nebivolol can be given. Non-dihydropyridine calcium channel blockers, such as diltiazem or verapamil, can be considered. And in some cases, cardiac glycosides, such as digoxin, have limited use.
Pacemakers. Your doctor may decide that you need a pacemaker to help regulate your heartbeat. The device will be surgically placed under your skin near your collarbone.
Surgery. If other treatments are not effective, maze heart surgery may be one option. A surgeon will make small cuts in the upper heart chamber to help disrupt the electrical signals that are causing atrial fibrillation. The doctor can sometimes access the heart through small incisions in the side of your chest – described as minimally invasive heart surgery. The benefits of minimally invasive surgery are that you have smaller, less noticeable scars, a lower risk of infection and less blood loss.
Follow-up care
Just as the diagnosis and treatment are important to your health, so is proper follow-up with your doctor. Do not think that just because you feel better, you don’t need to visit your doctor, as prescribed. At your follow-up visits, your doctor will monitor your heart rhythm and rate.
While atrial fibrillation can be due to non-cardiac causes – such as an acute illness or alcohol use, those who have no obvious cause for an irregular heartbeat are likely to have another episode sometime in their life. As a result, you need to stay in contact with your cardiologist until you are told otherwise.
Lifestyle changes
Your doctor may suggest you make some healthy lifestyle changes to improve your overall health or to help control high blood pressure. Some common suggestions are:
Eat heart-healthy foods
Get some exercise – to the extent that your doctor directs
Use less salt because salt can raise your blood pressure
Don’t smoke cigarettes
Limit your consumption of alcohol
The information provided in this article is for informational purposes only. It is not a substitute for medical advice. All medical information presented should be discussed with your healthcare professional. Remember, the failure to seek timely medical advice can have serious ramifications. We urge you to discuss any current health related problems you are experiencing with a healthcare professional immediately.
