Out Of Rhythm

Atrial fibrillation is very common, but so are two misconceptions about the condition

A person’s heart pumps blood by the signals given through electrical impulses. When these impulses arrive in an organized pattern or rhythm, the four chambers of the heart work well. However, if the electrical impulses in the upper chambers are fast or irregular, the heart’s ability to pump the right amount of blood through the body is impaired. This abnormal heart rhythm is called atrial fibrillation.

“Atrial fibrillation is extremely common,” says cardiologist and electrophysiologist Michael B. Chisner, MD. “Those who have it can sometimes be asymptomatic, regardless of their heart rate, while others may experience a very uncomfortable feeling of their heart racing and feeling weak or lightheaded.”
 
The condition can be a significant risk factor for stroke, a possibility that becomes more likely as a person gets older and encounters other medical conditions such as hypertension, diabetes, and vascular disease. However, younger people can also be diagnosed with atrial fibrillation.
 
“It is not necessarily an older person’s disease,” Chisner says. “That is a misconception.”
 
Depending on the individual patient’s needs, different medications can be used to slow an irregular heartbeat or to prevent episodes of atrial fibrillation from returning. Certain patients will be candidates for a surgical procedure known as a cardiac ablation. In this procedure, a catheter is inserted into blood vessels and guided to the heart with live x-ray images. Electrodes are placed in the heart to detect where the irregular impulses are originating. Once found, the tissue in this is cauterized, or burned, to stop it from conducting electricity.
 
“Treatment takes you into different directions, particularly for people who have a significant risk for blood clots in the heart that can go somewhere and cause a stroke,” Dr. Chisner says. “You need to not only try and help them feel better but also lower their risk for complications unrelated to how they are feeling.”
 
This additional treatment often requires the use of anticoagulants (also known as blood thinners, though that is a misnomer), which is the source of another misconception often seen by Dr. Chisner.
 
“Once a patient feels better, they sometimes have to grapple with the idea of taking anticoagulants,” Dr. Chisner says. “Some have a difficult time accepting that even though their heart rate is being controlled and they feel better, their risk is not lowered unless they continue taking anticoagulants, possibly for the rest of their life.”
 
When being treated for atrial fibrillation and its risk factors, it’s clear that patients should stay in step with their doctor’s recommendations, just as a healthy heart keeps a steady beat.
 
Learn more about atrial fibrillation by taking our  quiz.