What is atrial fibrillation, the diagnosis and treatment?
- Baris Gungor
- May 9, 2022
- 1 min read
Atrial fibrillation is a chronic rhythm problem that increases with age. It is a major cause of stroke in the population. As a result of the development of uncontrolled chaotic rhythm in the atria (auricles) of the heart, the rhythmic work of the heart's ventricles is also disrupted. (Sample video) Most of the patients present to the emergency department with the complaint of irregular heartbeat. However, some patients do not feel this rhythm disorder and are diagnosed with long-term complications such as heart failure and stroke. In fact, the majority of stroke patients (especially the elderly) in the community have underlying continuous or intermittent atrial fibrillation.
The diagnosis ?
Atrial fibrillation can easily be diagnosed on electrocardiography (ECG). However, additional examinations such as ultrasonography of the heart (Echocardiography), transesophageal echocardiography, or coronary angiography are often required to decide which method to use in the treatment.
What are the treatment options?
Except for emergencies, treatments to control heart rate and blood thinner treatments are started immediately. In most cases, atrial fibrillation is a chronic disease, which necessitates scheduled follow-up. Special rhythm-regulating drugs (anti-arrhythmics) are prescribed in order to restrore normal sinus rhythm. In patients unresponsive to medical therapies, electrical cardioversion and / or ablation therapies may be recommended by your doctors. Ablation procedures are performed by experienced centers specialized for arrhythmia diseases.
What is atrial fibrillation ablation (cryoablation)?
Atrial fibrillation ablation is a method applied to selected cases who do not respond to drug and cardioversion treatments for rhythm control. It is often applied by arrhythmia doctors (electophysiologist) using special equipment in the angiography room. It is done by entering the inguinal vein, and the abnormal electrical activity of the atria is tried to be terminated by burning or freezing (cryoablation) the ostia (mouths) of the pulmonary veins where the rhythm disturbance usually initiate.
The most important drugs for atrial fibrillation patients are anticoagulants (blood thinners). Irregular rhythm in the atria causes irregular and fast contraction of the heart. This causes pooling of blood in the atria and especially left atrial appendage. Any clot in the left side of the heart may cause embolic events such as occlusion of arteries in the body. If cerebral arteries are affected by these clot, patients suffer ischemic stroke which may be fatal or cause severe sequale such as paralysis or plegia. In order to prevent clot formation, atrial fibrillation patients have to use blood thinners throughout their lives.
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