FAQ - atrial fibrillation
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Is there a way to reverse atrial fibrillation?


If someone has a home remedy, I would welcome it. I have heard of soaking in a tub of Epsom's salts, etc.
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I would avoid natural remedies in this case -- the cardio drugs are very touchy in terms of dosing (you will probably get blood tests if, for example, they use wafarin). And foxglove is lethal while digitalis is ok. The therapeutic range is fairly small. And the consequences of failure to treat (higher risk of stroke, etc.) are pretty significant.

The other way is cardio version (electric shock to your heart -- you will be sedated first).

Still, if you want the natural thing -- go to a naturopath. Do not rely on the internet or a health food store. This is serious and deserves the attention of someone with at least a ND. Personally, I would want a board certified cardiologist....  (+ info)

what is atrial fibrillation and can it kill?


my father recently found out he has it, and he's one of those people that doesn't like to talk about illnesses and things, so i just want to know what it is, and if its life threatening.
thanks :)
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Ok, your heart is made of four chambers, The two atria are at the top and the two ventricles at the bottom. You have a left and right of each. The ventricles do the main pumping of the blood around the body, and are fed by the atria.

In AF (atrial fibrillation), instead of rhythmic contractions of the atria, they fibrillate, which more or less looks like quivering. It's because for whatever reason the normal electrical pathway has become interrupted.

There are all sorts of treatments, and with it being a common thing for older people to get, the GP should be right on it with the treatments which in the UK range from daily aspirin to getting your heart shocked to try to get it back into the proper rhythm.

The problem with AF is that is can cause blood clots to form in the atria due to the turbulence of the blood. These, if big enough, can travel through the blood system and cause stuff like strokes. For this reason it's really important to keep to whatever regime the Dr advises, and take general health measures like reducing salt, exercising etc to decrease the other risk factors.

Hope this helps.  (+ info)

I would like to know if anyone has had success personally with use of acupuncture to treat atrial fibrillation?


I have a case of it and medicine doesn't seem to help much, and I want to avoid the ablation surgery if possible.
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Understanding the treatment of Atrial Fibrillation for the non-medical person


First of all I am a Cradiac Electrophysiologist.

Atrial Fibrillation (AF) is a common disorder that affects many individuals, the incidence and oreveral prevalence of which increases with age. There is another form of AF that affects younger people starting in the twenties, called Lone AF and this does not carry the same degree of complication but you still need to have this evaluated by an EP specialist.

Regardless, the treatment goals of AF remain about the same, with some exceptions.
The 3 goals to the treatment of AF are as follows:
1.Rate control.
2.Anticoagulation
3.Maintaince of normal rhythm (Normal sinus rhythm (NSR))

Rate control:
Rate control refers to the control of the heart rate in the lower chambers or the ventricles. AF arises from the upper chambers (ATRIA/ATRIUM), hence ATRIAL Fibrillation. The rate in the lower chambers is controlled by the impulses going through the VA Node; therefore the measures aimed at rate control have to affect the AV Node. This is achieved by the use of medications that act on the AV Node; hence slowing the number of impulses that node allows to enter the Ventricles or the lower chambers. This is the first important step in the treatment. If the lower chambers are allowed to beat too fast for too long ( as little as three weeks at a rate of greater than 130) the lower chambers will not perform at their full capacity and this can lead to a condition known as Tachycardiomyopathy ( Tachy meaning fast, Cardio meaning heart a Myopathy meaning disease of a muscle. In this case the heart muscle)
With appropriate treatment the lower chambers should be beating at less than 90 beats per minute at rest.
The medications that are used to act on the AV Node include Beta Blockers, Calcium Channel Blockers and at a later stage drugs called Antiarrhythmic Drugs (AAD) that act both on the Atrium and on the AV Node. (more about this bellow)

ANTICOAGULATION:
Refers to the blood thinners that are used to prevent blood clots in the Atrium. These clots occur due to the stagnation of blood in the Atrium when it is in Fibrillation ( not really contracting as normal) . These clots have a possibility of dislodging and going downstream and blocking the blood supply to critical organs the most important one being the Brain, leading to a stroke. The chances of having a stroke while in AF are in the order of 2 to 5% per year, depending on other risk factors. Regardless a 2%/Year risk adds up to a 20% chance at the end of 10 years and a 5%/Year risk adds up to 50% at the end of 10 years. Both of these are preventable and not an accepted end point to the treatment of this disorder.
Anticoagulation/ Blood thinning is achieved by the use of Coumadin/ Warfarin used orally or Heparin/ Lovenox used while in the hospital. Some people shy away from the use of Coumadin because it s the same substance present in rat poison. It is true that Coumadin/Warfarrin is used as rat poison because the rats are given a very high lethal dose that kills them due to bleeding in the brain. In human medicine this dose is very low and controlled by frequent blood tests and therefore does not have the same effect as in rats. The one example that I can offer is that Potassium Chloride is given to save patients lives in cases where the body has too little Potassium, yet it is also administered in very high doses as a lethal injection as a means of the death penalty. So it’s the dose that matters and patients are monitored very closely
Maintaince of normal rhythm (Normal sinus rhythm (NSR)) :
This is the final step in the treatment of AF, and probably the most important after the first two have been achieved. The aim here is to get rid of AF completely or at least to a point where it does not happen as often.
Every person who goes into AF should be given a chance at reverting back to Normal Rhythm, no exceptions. This can be achieved by the following
1.Most new cases of AF will spontaneously revert back to Normal Rhythm in the first 24 hours from onset. As the clock draws closer to the 24 hour mark, one should have already initiated anticoagulation with either IV Heparin/ or S/C Lovenox and Coumadin. If the Blood thinning numbers are at optimum values in the first 24 hours i.e. INR greater than 2.0, then cardioversion with an electric shock should be done ASAP. (the patient is under short lasting Anesthesia during this procedure and should not feel any pain or discomfort nor have any memory of the procedure)

2.If the previous step is not successful then the patient would have to given an Antiarrhythmic drug, continued on the Anticoagulation and the cardioversion repeated in 4 to 21 days depending on the drug being used.

3.If the maintaince of normal rhythm is still unsuccessful, then either another drug can be tried with a repeat cardioversion or the patients referred for an Ablation for AF.

Regarding accupuncture, dont even go there and waste you time. you could have stroke by then. accupunture does not treat heart disese, no matter what the accupuncurits may have you believe.  (+ info)

what is the cause of atrial fibrillation in me?


i am 48 years old male. i had first episode of AF IN 1997. since then i had suffered several times. i have been taking antihypertensive treatment regularly since now almost 12 years.last episode of AF occurred just last night when after taking dinner i was watching TV. suddenly i felt some unusual THING has started in my chest. i knew it was the same old problem of AF.i took a tranquillizer and went to sleep. in the morning i felt better but not 100%. my ECG showed that my beat was still irregular. while i was waiting for my cardiologist i felt AF has stopped. a subsequent ECG showed sinus rhythm. my blood pressure was normal. in span of 8 days i had two episodes of AF. STRANGELY enough theses two episodes occured while i was awake. while previous all (may be10-12 since 1997) occured at night during sleep. my thyroid function is normal. echocardiography shows no structural problem in my heart.
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I don't have enough information to tell for sure, but I suspect the afib is related to left atrial enlargement from years and years of hypertension. Talk to your physician about whether you might benefit from antiarrhythmic drugs or an ablation in the area of the pulmonary veins. Afib is bothersome because it tends to come back---through no fault of the patient or the physician caring for him. So don't blame yourself. This rhythm is a nuisance. Hang in there.  (+ info)

How would you treat Atrial Fibrillation with a Low Ejection Fraction?


Followings are the three methods performed by different school of thoughts:

1)Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function.
OBJECTIVES: We aimed to determine the safety and efficacy of pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with impaired left ventricular (LV) systolic function.

BACKGROUND: To date, PVI has been performed primarily in patients with normal LV function. Yet, many AF patients have impaired LV systolic function. The outcomes of PVI in patients with impaired LV systolic function are unknown.

METHODS: We included 377 consecutive patients undergoing PVI between December 2000 and January 2003. Ninety-four patients had impaired LV function (ejection fraction [EF] <40%), and they comprised the study group. The control group was the remaining 283 patients who had a normal EF. End points included AF recurrence and changes in EF and quality of life (QoL).

RESULTS: Mean EF was 36% in our study group, compared with 54% in controls. After initial PVI, 73% of patients with impaired EF and 87% of patients with normal EF were free of AF recurrence at 14 ± 6 months (p = 0.03). In the study group, there was a nonsignificant increase in EF of 4.6% and significant improvement in QoL. Complication rates were low and included a 1% risk of pulmonary vein stenosis.

CONCLUSIONS: Although the AF recurrence rate after initial PVI in impaired EF patients was higher than in normal EF subjects, nearly three-fourths of patients with impaired EF remained AF-free. Although our sample size was nonrandomized, our results suggest PVI may be a feasible therapeutic option in AF patients with impaired EF. Randomized studies with more patients and longer follow-up are warranted.

2)Catheter Ablation of Atrial Fibrillation. A 74-year-old man with atrial fibrillation (AF) underwent electrophysiologic study and catheter ablation with a noncontact mapping system. AF was induced by coronary sinus pacing, and noncontact mapping showed ever-changing movement of multiple wavefronts with one dominant reentrant circuit around the tricuspid annulus, splitting wavefront conduction through the gaps in the crista terminalis, and then fusion and stasis of wavefronts. After creation of bidirectional conduction block over crista terminalis gaps and the cavotricuspid isthmus, AF or atrial flutter was noninducible. No further AF recurrence was noted during 6-month follow-up.

3)Irrigated-Tip Catheter Ablation of PVs. Introduction: Catheter ablation of pulmonary veins (PV) for treatment of atrial fibrillation (AF) is limited by the disparate requirements of sufficient energy delivery to achieve PV isolation while avoiding PV stenosis. The aim of the present study was to evaluate the safety and efficacy of using an irrigated-tip catheter for systematic isolation of PV.

Methods and Results: The study population consisted of 136 consecutive patients (109 men, mean age 52 ± 10 years) with symptomatic, drug-refractory paroxysmal (122) or persistent (14) AF. Cavotricuspid isthmus ablation and systematic radiofrequency isolation of all four PVs (guided by a circumferential mapping catheter) was performed in all patients with a protocol using an irrigated-tip catheter. PV diameter was assessed by selective angiography. The electrophysiologic endpoint of PV isolation was achieved in 100% of patients. Bidirectional cavotricuspid isthmus block was achieved in 99% of patients. Moderate PV stenosis (50% narrowing) was observed in one patient (0.7%) without clinical consequence. No other complications were observed. Reablation procedures were required in 67 patients (49%). After a mean follow-up of 8.8 ± 5.3 months, 81% of patients were free of AF clinical recurrence, including 66% not taking any antiarrhythmic drugs.

Conclusion: Systematic radiofrequency ablation of PV using an irrigated-tip catheter in patients with atrial fibrillation allows complete isolation of all four PVs with a very low incidence of stenosis.  (+ info)

Do you know the cure for irregular heartbeat(Atrial fibrillation)?


I get irregular heartbeat when I drink a lot of coffee, tea or any drinks with caffeine. Sometimes it happens by no reasons.
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It is easy, leave the above things, as it's a precipitating cause of your atrial fibrillation.
Next you can use a calcium channel blocker, or in extreme cases a ICD is implanted.
Talk it out with your doctor, may be he will run a couple of tests.  (+ info)

how long can a 70something yr.old man live with congestive heart failure and atrial fibrillation?


just worried about my father-in-law.
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Atrial fibrillation is really not as bad as it sounds. Congestive heart failure may be a little serious, but if you F-I-L watches his diet and is relatively active, he could look forward to a long life into his 80's or 90's.

Have fun  (+ info)

What are the long term effects of taking metoprolol for Atrial Fibrillation?


??

It is to reduce heart rate and blood pressure.  (+ info)

How long should I have an atrial fibrillation before going to A & E? The last one was 10 hours.?


When I went to hospital as an emergency (fibrillations coming every other day in spite of lots of medication) I was told that the
10 hours I waited was too long to be in fibrillation . Today the nurse at the local surgery who did my INR said 3 - 4 hours was long enough to wait to see if it would stop. I don't want to go to A & E for nothing but I don't want to have to be admitted as I was 2 weeks ago. Nobody here seems to have the answer. What experiences have others had?
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Some people have AF as a long-term condition - usually older people - and manage it with medication and regular check-ups, but any cardiac discomfort is worth going to A&E as soon as poss for - it's not worth the risk.  (+ info)

Can Atrial Fibrillation be related to Mental Stress?


Right now, my dad has been diagnosed with a-fib for a few years. They have ran quite a few tests and are finding the cause. Instead, the doctors have been prescribing medication which has been progressively increased over time which now has caused an indigestion problem.

For the past few years, he has not only faced this health problem but other stressful events that are mentally stressful than physically stressful. He can perform physical work fine, but when he falls for some reason, his heart goes out of sync, but he is also thinking about the effect of what is hurt and not being able to be with his friends later.
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Atrial Fibrillation is a physical problem, often controlled with meds, sometimes requiring other interventions.
The mental stress your dad is experienceing isn't causing the afib, but could indeed contribute to the severity of it. I strongly suggest you get your dad into counselling.  (+ info)

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