Dr. Miret Habashy-Ibrahim is a cardiologist at Lowell General Hospital’s Heart and Vascular Center and Medical Director of the Anticoagulation Management Service. She is board certified in internal medicine, general cardiology, nuclear cardiology and echocardiography. Here she discusses the diagnosis and treatment of AFib.
AFib stands for atrial fibrillation. It is a type of arrhythmia or irregular heart rhythm that originates from the atria, or top chambers of the heart. The atria beat so fast that they do not contract well and described as ‘fibrillating.’ It is a relatively common condition affecting nearly 3 million Americans.
Many people will describe their heart skipping beats, a racing heartbeat, shortness of breath, and a feeling of lightheadedness or nausea, especially when standing up or bending over. But others feel very light symptoms or none at all and have it discovered on a routine checkup
Many people don’t realize that AFib is a serious condition. If the heart is not moving blood effectively, it can clot. If that clot then lodges in an artery that feeds the brain, it will cause a stroke. Untreated AFib can double the risk of heart-related death and increases the chance for stroke by five times.
People of any age can develop AFib, but the chances increase with age. Patients with high blood pressure, diabetes, congestive heart failure and prior stroke are at greatest risk. Other risk factors include other forms of heart disease, family history, smoking, excessive alcohol use, sleep apnea, prolonged athletic conditioning, and chronic conditions like diabetes, asthma and thyroid problems.
Common triggers include energy drinks, excessive alcohol, too much caffeine, stress, anxiety or poor sleep. For others, exercise that raises the heart rate above a certain level can be a trigger.
Treatment starts with a thorough examination with a cardiologist. Though clots are not 100% preventable, the condition is usually treated with medication to slow the heart rate down and blood thinners to prevent stroke. If there is an underlying cause, such as hypothyroidism, treating that cause can be very effective.
A cardiologist may recommend electrical cardioversion, a procedure that shocks the heart in an effort to reset the proper rhythm. Another option is an ablation, where an interventional cardiologist inserts a catheter through the blood vessels and into the heart. The catheter is used to deliver energy that scars the area sending abnormal signals to the heart. Depending on the area of the heart triggering the AFib, a pacemaker may need to be implanted as well.