Notes

Atrial Fibrillation

Abnormal heart rhythm.Encyclopedia Entry for Atrial Fibrillation :Atrial fibrillation - discharge. Have all of your prescriptions filled before you go home. You should take your medicines the way your health care provider has told you to. Tell your provider about other medicines you are taking including over-the-counter medicines, herbs, or supplements. Ask if it is ok to keep taking these. Also, tell your provider if you are taking antacids. Never stop taking any of your medicines without first talking to your provider. DO NOT skip a dose unless you are told to. You may be taking aspirin or clopidogrel (Plavix), warfarin (Coumadin), heparin, or another blood thinner such as Apixiban (Eliquis), Rivaroxaban (Xarelto), Dabigatran (Pradaxa) to help keep your blood from clotting. If you are taking any blood thinner: You need to watch for any bleeding or bruising, and let your provider know if it happens. Tell dentist, pharmacist, and other providers that you are taking this drug. You will need to have extra blood tests to make sure your dose is correct if you are taking warfarin.Limit how much alcohol you drink. Ask your provider when it is ok to drink, and how much is safe. DO NOT smoke cigarettes. If you do smoke, your provider can help you quit. Follow a heart healthy diet. Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a dietitian, who can help you plan a healthy diet. If you take warfarin, DO NOT make big changes in your diet or take vitamins without checking with your doctor. Try to avoid stressful situations. Tell your provider if you feel stressed or sad. Talking to a counselor may help. Learn how to check your pulse, and check it every day. It is better to take your own pulse than to use a machine. A machine may be less accurate because of atrial fibrillation. Limit the amount of caffeine you drink (found in coffee, tea, colas, and many other beverages.) DO NOT use cocaine, amphetamines, or any other illegal drugs. They may make your heart beat faster, and cause permanent damage to your heart.Call for emergency help if you feel: Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw Shortness of breath Gas pains or indigestion Sweaty, or if you lose color Lightheaded Fast heartbeat, irregular heartbeat, or your heart is pounding uncomfortably Numbness or weakness in your face, arm, or leg Blurry or decreased vision Problems speaking or understanding speech Dizziness, loss of balance, or falling Severe headache Bleeding.Auricular fibrillation - discharge; A-fib - discharge; AF - discharge; Afib - discharge.January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1-76. PMID: 24685669 www.ncbi.nlm.nih.gov/pubmed/24685669. Morady F, Zipes DP. Atrial fibrillation: clinical features, mechanisms, and management.Encyclopedia Entry for Atrial Fibrillation :Atrial fibrillation or flutter. When working well, the 4 chambers of the heart contract (squeeze) in an organized way. Electrical signals direct your heart to pump the right amount of blood for your body's needs. The signals begin in an area called the sinoatrial node (also called the sinus node or SA node). Conduction system of the heart In atrial fibrillation, the electrical impulse of the heart is not regular. This is because the sinoatrial node no longer controls the heart rhythm. Parts of the heart cannot contract in an organized pattern. As a result, the heart cannot pump enough blood to meet the body's needs. In atrial flutter, the ventricles (lower heart chambers) may beat very rapidly, but in a regular pattern. These problems can affect both men and women. They become more common with increasing age. Common causes of atrial fibrillation include: Alcohol use (especially binge drinking) Coronary artery disease Heart attack or heart bypass surgery Heart failure or an enlarged heart Heart valve disease (most often the mitral valve) Hypertension Medicines Overactive thyroid gland ( hyperthyroidism ) Pericarditis Sick sinus syndrome.You may not be aware that your heart is not beating in a normal pattern. Symptoms may start or stop suddenly. This is because atrial fibrillation may stop or start on its own. Symptoms may include: Pulse that feels rapid, racing, pounding, fluttering, irregular, or too slow Sensation of feeling the heart beat ( palpitations ) Confusion Dizziness , lightheadedness Fainting Fatigue Loss of ability to exercise Shortness of breath.The health care provider may hear a fast heartbeat while listening to your heart with a stethoscope. Your pulse may feel fast, uneven, or both. The normal heart rate is 60 to 100 beats per minute. In atrial fibrillation or flutter, the heart rate may be 100 to 175 beats per minute. Blood pressure may be normal or low. An ECG (a test that records the electrical activity of the heart) may show atrial fibrillation or atrial flutter. If your abnormal heart rhythm comes and goes, you may need to wear a special monitor to diagnose the problem. The monitor records the heart's rhythms over a period of time. Event monitor (3 to 4 weeks) Holter monitor (24-hour test) Implanted loop recorder (extended monitoring) Tests to find heart disease may include: Echocardiogram (ultrasound imaging of the heart) Tests to examine the blood supply of the heart muscle Tests to study the heart's electrical system.Cardioversion treatment is used to get the heart back into a normal rhythm right away. There are two options for treatment: Electric shocks to your heart Drugs given through a vein These treatments may be done as emergency methods, or planned ahead of time. Daily medicines taken by mouth are used to: Slow the irregular heartbeat. These drugs may include beta-blockers, calcium channel blockers, and digoxin. Prevent atrial fibrillation from coming back. These drugs work well in many people, but they can have serious side effects. Atrial fibrillation returns in many people, even while they are taking these medicines. Blood thinners are medicines that are used to reduce the risk of developing a blood clot that travels in the body (and that can cause a stroke, for example). They include heparin , warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Savaysa) and dabigatran (Pradaxa). These drugs increase the chance of bleeding, so not everyone can use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your provider will consider your age and other medical problems when deciding which drugs are best. A procedure called radiofrequency ablation can be used to scar areas in your heart where the heart rhythm problems are triggered. This can prevent the abnormal electrical signals that cause atrial fibrillation or flutter from moving through the heart. You may need a heart pacemaker after this procedure. All people with atrial fibrillation will need to learn how to manage this condition at home.Treatment can often control this disorder. Many people with atrial fibrillation do very well. Atrial fibrillation tends to return and get worse. It may come back, even with treatment. Clots that break off and travel to the brain can cause a stroke.Call your provider if you have symptoms of atrial fibrillation or flutter.Talk to your provider about steps to treat conditions that cause atrial fibrillation and flutter. Avoid binge drinking.Auricular fibrillation; A-fib; Afib.Atrial fibrillation - discharge Heart pacemaker - discharge Taking warfarin (Coumadin, Jantoven) - what to ask your doctor.Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Posterior heart arteries Posterior heart arteries Anterior heart arteries Anterior heart arteries Conduction system of the heart Conduction system of the heart.January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-2104. PMID: 24682348 www.ncbi.nlm.nih.gov/pubmed/24682348. Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838. Morady F, Zipes DP. Atrial fibrillation: clinical features, mechanisms, and management.