What it is and how to deal with it: Atrial Fibrillation

What is Atrial Fibrillation and how do I deal with it

To understand what atrial fibrillation is we first have to understand what is happening with a healthy heart.  Though the heart is a complicated organ with a very serious job to do, we can picture the heart quite simply – picture two sets of paired chambers, one larger pair sits on top of the lower, smaller pair.  The larger chambers are known as atria (or atrium if singular) and the lower chambers are known as ventricles. 

The atrium’s job is to collect the blood as it enters the heart and then to push this blood into the ventricle sitting below it which will in turn, expel the blood from the heart under pressure as it starts its journey around the body again.  This results in the double-beat of the normal, healthy heart as first the atrium contracts and then the ventricle – this is known as the Sinus Rhythm by doctors.  How this is all coordinated is the responsibility of a part of the heart located at the top of the right atrium – this is known as the Sinus Node or he Sinoatrial Node (the SA Node) – this is the heart’s natural pacemaker.  The electrical signal travels across the right to the left atrium and ends at the Atrioventricular Node (the AV Node) and when received, the atrium contracts just before the beat of the ventricles.

Now atrial fibrillation occurs where the electrical signal bypasses the atrium (hence the “atrial” term) – the atrium doesn’t contract properly and instead, it “fibrillates” and to imagine this, think of a jelly on a plate when it is shook.  What causes the electrical signal to bypass the atrium or to deteriorate which also can cause the condition may be damage to the SA Node or some other condition.Regardless of the cause, symptoms can go unnoticed until something serious like a heart attack or stroke occurs.  This is why it is important to have regular cardiac screenings which can identify the condition early.

Those with a history of heart problems, rheumatic fever, diabetes or strokes are all in a higher risk category for contracting atrial fibrillation.  Symptoms that present themselves may include shortness of breath, intolerance to exercise, palpitations and sometimes even angina.  The condition lends itself to treatment with mild instances not requiring any treatment where the patient is not in a high risk group or the symptoms are not creating issues for the patient.  First stage treatment includes medication to control the heart rhythm and the use of catheters though open-heart surgery may be required using an operation known as the Maze Procedure. 

The Maze procedure consists of making incisions in the atrium and sewing them up again; this allows the atrium to hold blood and contract normally but the electrical signal cannot traverse the incisions that have been made – the signal must follow the route which is delineated by the incisions and cannot, therefore, bypass the atrium.Sometimes an artificial pacemaker will need to take the place of the SA Node that is damaged by the disease.  The success rate is high with 80% to 100% success rate being reported.