May 22, 2019 by John Fernandez and Tanya Racoobian
Get Control of AFib (Video)
Many people affected by atrial fibrillation (AFib) do not realize they have it and those who have it may not realize the seriousness of the condition.
AFib is the most common irregular heartbeat disease, says Ramon Quesada, M.D., medical director of the Structural Heart and Complex Percutaneous Coronary Intervention Programs at Miami Cardiac & Vascular Institute at Baptist Hospital. It also is the most serious. AFib increases your risk of stroke five-fold. The abnormal heart rhythm causes blood to pool in the atria and form clots, which can then break loose, block the arteries and deprive the brain of oxygen. Stroke is responsible for one out of 20 deaths in the U.S. and is the leading cause of disability, according to the Centers for Disease Control and Prevention.
Video: The Baptist Health News Team hears from Ramon Quesada, M.D., medical director of the Structural Heart and Complex PCI Programs at Miami Cardiac & Vascular Institute at Baptist Hospital, about AFib (atrial fibrillation). Video by George Carvalho.)
AFib Risk Factors
As people age, their risk of AFib increases, Dr. Quesada says. Older adults are more likely to have health problems that can lead to the heart arrhythmia. These include heart disease, high blood pressure, obstructive sleep apnea, diabetes, kidney disease, lung problems and thyroid disorders. Many experts recommend that people over age 60 who have one or more of these risk factors be screened for asymptomatic AFib.
In about 27 percent of Afib-related strokes, Afib had not been detected prior to the stroke. That’s because the condition often is asymptomatic. When symptoms are present they include heart palpitations, dizziness and shortness of breath. Dr. Quesada recommends people with these symptoms talk to their doctor. “The consequences of atrial fibrillation can be catastrophic, especially for older adults,” he said. “The condition and its potential complications need to be treated.”
A physician can detect AFib by reviewing a patient’s symptoms and medical history and conducting a physical exam, which includes taking the pulse at rest and checking for a heartbeat that is regular, like a clock. AFib can be decisively diagnosed through tests, such as an electrocardiogram (ECG).
Diagnosing AFib and treating it with anticoagulant medications and other therapies could prevent thousands of strokes worldwide each year, says a panel of experts from the American Heart Association. The most common treatments for the heart arrhythmia include:
- Medication or electrical cardioversion to control the heart rate or heart rhythm.
- Anticoagulation medications such as Coumadin or warfarin to avoid blood clots and decrease the risk of stroke.
When medications or cardioversion do not control AFib, Dr. Quesada recommends advanced treatments such as catheter ablation or surgical maze procedure. “We map the heart and find the focus of the arrhythmia,” he explained. “These techniques destroy the area of the heart’s tissue that is causing the erratic electrical signals and restores the heart to a normal rhythm.”
For patients who have an increased risk of blood clots and bleeding, and who are not able to take anticoagulants on a long-term basis, Dr. Quesada may perform a left atrial appendage closure. This minimally invasive procedure may reduce the risk of blood clots in certain people with AFib, as many blood clots that occur with AFib form in the left atrial appendage.
Atrial fibrillation is never benign. “It can and should be controlled with medications and procedures,” Dr. Quesada said. “It’s important for people to partner with their cardiologist to determine the best treatment protocol.”