Your Fluttering Heart Could Signal Something Serious
A Dean & St. Mary's cardiovascular surgeon explains Atrial Fibrillation
February is national heart month – a time to remember that a racing heart may be due to something serious.
If your heart feels like its racing or you feel a fluttering, palpitations or shortness of breath you could be experiencing atrial fibrillation which affects as many as 3 million people in the U.S. alone.
“Atrial fibrillation affects the top two chambers of the heart,” says Dean & St. Mary’s cardiovascular surgeon Dr. John Snider. “It’s an irregular, fast rhythm of the atria – almost a quivering of sorts. And the bottom chambers try to keep up but they can’t.”
It isn’t something patients always notice. Their heart may beat irregularly for as little as a few minutes to a few hours a month. But for some, the fluttering is non-stop and more apparent.
“The amount of atrial fibrillation you have really affects how much you are made uncomfortable by this condition,” says Dr. Snider. “The people who experience it intermittently usually feel it each time it happens, while those who have it fairly regularly don’t feel it much or at all.”
Atrial fibrillation, in and of itself, is usually not life threatening. However, because the atria are quivering rather than beating, they do not empty blood like the heart normally would. Over time this can lead to clotting which, once out of the heart, can cause stroke.
“This clotting makes atrial fibrillation one of the leading causes of stroke,” says Dr. Snider.
In fact, a person with atrial fibrillation has a five to six times greater chance of stroke than someone their age without the condition.
How is atrial fibrillation treated?
If your doctor diagnoses you with atrial fibrillation you may have several options for treatment. First, your risk for stroke will be assessed using something called a CHADS score. Your height, weight and other medical conditions will be factors in determining whether you should be taking blood thinning medication.
Another option might include a new type of medicine called an anti-arrhythmic.
“Those aren’t effective for everyone but for a minority of people it can solve their problems,” says Dr. Snider.
Other medicines won’t cure atrial fibrillation but do work to keep your heart in check. For these patients, the medicine acts as a regulator preventing the heart beats from getting out of control.
For patients with more severe cases, a procedure called catheter-based ablation may be needed.
“In these procedures an electro physiologist will insert a catheter – much like is used to treat a heart attack – up through your femoral artery to your heart. Then they use microwave technology or freeze heart tissue to discourage atrial fibrillation from beginning,” says Dr. Snider.
This method can work for many people but sometimes it doesn’t work the first time. For those who’ve had the procedure done two times or more, a surgical procedure – mini-Maze – may be advised.
“For the mini-Maze procedure we use a series of ports (openings in the skin) – each about 1cm long. We insert a small camera and use it to guide us to the heart. Then we use a special tool to disrupt the erratic electrical flow in the heart to get rid of the atrial fibrillation,” says Dr. Snider. “This technique means less pain afterwards, a shorter length of stay and recovery is quick – about 2 weeks.”
This procedure can end atrial fibrillation for about 80 percent of patients.
That’s welcome news for the millions suffering from the disorder. And due to an aging population, millions more are expected to be affected in the future.
“It’s definitely not an uncommon issue,” says Dr. Snider. “A lot of people in their 70s or 80s think they’re just getting old when they start having symptoms but that’s not the case. The symptoms are subtle. Check your pulse. If it’s irregular you have a high chance of atrial fibrillation and should call your doctor.”