Atrial Fibrillation

Often referred to as A-fib, atrial fibrillation is a very common heart rhythm disorder. It affects about 2.5 million Americans.  During atrial fibrillation, the heart’s two small upper chambers (the atria) quiver instead of beating effectively. Although it is not life threatening, A-fib can lead to other problems, such as fatigue, congestive heart failure or stroke.

What is atrial fibrillation?

Normally, the heart pumps in a well-timed fashion using the heart’s own electrical system. The two upper chambers (atria) contract first, followed by the two lower chambers (ventricles). This coordinated pumping is powered by the heart's own electrical system and efficiently pumps blood out to the body and back.

During a-fib, the electrical signals fire rapidly and chaotically, causing the two upper heart chambers to quiver instead of contracting normally. These electrical signals may hit the lower chambers, too, causing them to contract irregularly. This results in a fast and irregular heart rhythm. Over time, this can weaken the heart and lead to heart failure.

A-fib sufferers may also be at higher risk for stroke. When the heart chambers do not work properly, blood pools in the heart.  This increases the risk that a blood clot may form and travel to the brain causing a stroke. About 15 percent of strokes occur in people with atrial fibrillation.

What are the symptoms of atrial fibrillation?

Those suffering from a-fib may not experience any symptoms, but others report:

  • Heart palpitations or fluttering in the chest
  • Chest pain
  • Shortness of breath
  • Fatigue
  • Anxiety
  • Dizziness and faintness

Some people with a-fib have intermittent episodes. Others have chronic or persistent a-fib.

What causes atrial fibrillation?

A-fib may develop after a heart attack or when one of the following conditions is also present:

  • Heart failure
  • High blood pressure
  • Thyroid problems
  • Alcoholism
  • Sleep apnea 
  • Lung disease
  • Electrolyte imbalance
  • Drug abuse

The likelihood of developing atrial fibrillation increases with age. About 3-5 percent of people over 65 have atrial fibrillation. The condition is more common in people who are over 65 and is seen more often in men than women.

How is atrial fibrillation treated?

Depending on the severity of your atrial fibrillation and symptoms, treatment options may range from no treatment to medication to surgery.

For some people, the heart returns to its normal rhythm and no treatment is necessary. When the heart does not naturally return to its normal heartbeat, your care team will help you decide the next step in treatment.

Medications for Rhythm Control

The next step in your treatment for atrial fibrillation may be an anti-arrhythmic medication, such as sodium channel blockers or potassium channel blockers, to slow the heart's ability to send electrical signals. These help control the heart rate. Here are some examples. 

  • Beta blockers, such as atenolol or metoprolol. These drugs slow the heart rate.
  • Calcium channel blockers, such as diltiazem or verapamil. These drugs also slow the heart rate.
  • Digoxin. This drug slows the electrical currents between the upper and lower chambers.

Patients with a-fib may be prescribed blood thinners to reduce the risk for stroke. This may include aspirin, clopidogrel, warfarin, dabigatran, or rivaroxaban. Your doctor will have a detailed discussion with you about which blood-thinning medications are most appropriate for you.


If the heart cannot return to its regular rhythm naturally or though medications, a procedure called cardioversion may be used to “reset” the heart back to its normal heart rate. Cardioversion Procedure

Catheter Ablation

Another option to return the heart back to its normal rhythm is a catheter ablation. During this procedure, a catheter is guided through a blood vessel to the heart to destroy the heart tissue causing the arrhythmia. Non-Surgical Catheter Ablation Technique

The latest research demonstrates that patients who develop a-fib will experience a worsening of their arrhythmia over time, and prolonging a cardiac ablation may negatively affect the outcome. This study concluded that upon diagnosis, a cardiac ablation may be the best immediate treatment.

Maze Procedures

This is a surgical procedure in which areas of the heart are cut to create a "maze" of scar tissue that prevents the erratic electrical signals from passing through the heart. MAZE Surgery Procedures

For more information on arrhythmia or to schedule an appointment, call us at 314-996-9627 or contact us online.

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