This is the fourth in our February Medical Monday series on heart health. Dr. Kirsten O. Healy, a new member of the WVFC Medical Advisory Board, has generously agreed to write about cardiovascular and heart health for Medical Monday all this month. Earlier this month she wrote about “High Blood Pressure: 10 Important Questions That Could Save Your Life,” “7 Steps to a Heart Healthy Life,” and “Coronary Artery Disease.” Today, she discusses atrial fibrillation, a condition in which the heart beats in an abnormal way. More than 750,000 hospitalizations occur each year because of atrial fibrillation. This condition contributes to an estimated 130,000 deaths each year. The death rate from this heart rate abnormality as the primary or a contributing cause of death has been rising for more than two decades.
Dr. Healy has been a cardiologist at New York Cardiology Associates since 2010 and is an attending cardiologist at New York-Presbyterian Hospital, Weill Cornell Medical Center. She is board certified in both internal medicine and cardiology, and is a Fellow of the American College of Cardiology. Dr. Healy completed her fellowship training at the New York-Presbyterian Hospital, Weill Cornell Medical Center with a focus on clinical cardiology and echocardiography. She has presented papers at numerous national conferences and was the recipient of the American Heart Association Women in Cardiology Trainee Award for Excellence as well as the American Heart Association Laennec Young Clinician Award.
I encourage you to share her thoughtful February posts with friends and family in your community as WVFC joins with many other organizations to raise awareness about prevention and early detection of cardiovascular illness. Remember: Heart disease is the No. 1 killer of women in the United States. — Dr. Patricia Yarberry Allen
1. What is atrial fibrillation?
Atrial fibrillation is a type of arrhythmia that originates in the upper chambers of the heart (atria) and causes an irregular heartbeat. Normally, electrical signals that cause the heart to contract and pump blood originate in the sinus node in the right atrium. However, with atrial fibrillation, the electrical impulses are disorganized and scattered throughout both atria, interrupting normal conduction of the heart. In certain situations, this irregular heart rhythm makes it difficult for the heart to contract normally. This can lead to decreased blood flow and oxygen throughout the body.
2. What are the symptoms of atrial fibrillation?
The most common symptom of atrial fibrillation is palpitations or the sensation of a racing, uncontrolled heartbeat. Fatigue and weakness are also common presenting symptoms and are more common in the elderly. Dyspnea on exertion can occur when heart rates are uncontrolled with walking and therefore blood flow is not meeting the increased oxygen demands. Atrial fibrillation seldom presents with syncope, or loss of consciousness, and if a syncopal episode occurs, other arrhythmias should be considered. “Silent atrial fibrillation” is an asymptomatic form of atrial fibrillation where patients report no symptoms. This is diagnosed in a routine examination or when patients present with a complication related to atrial fibrillation, like a stroke.
3. How long does atrial fibrillation last?
Atrial fibrillation may be transient or constant. It is important to understand the frequency of the atrial fibrillation to appropriately tailor the treatment. The three main types of atrial fibrillation are:
- Paroxysmal atrial fibrillation is when the atrial fibrillation is intermittent and can last less than one week. It may happen for a few minutes at a time or can occur for several days. Often this type of atrial fibrillation is brief and medications are not needed.
- Persistent atrial fibrillation usually lasts longer than a week. Medications and other treatment, like a cardioversion (see below), are usually used to treat this type of atrial fibrillation to restore normal rhythm.
- Permanent atrial fibrillation lasts longer than a year and does not go away. It cannot be corrected by medications. Control of the rate of atrial fibrillation is important as well as appropriate treatment for the prevention of stroke.