2Presented by… Erin Rindels, MSN, RN, CNRN, SCRN Stroke Nurse CoordinatorUniversity of Iowa Hospitals and Clinics
3Have you ever noticed if your heart has missed a beat? If you have, you may be experiencing an arrhythmia.Atrial Fibrillation (A Fib) is the most common type ofarrhythmiaA Fib damages the heart’s electrical system, leading to increased risk for stroke, heart attack & heart failure.A Fib is an independent risk factor for stroke, increasing risk five fold.Most people have felt their heart race or skip a beat either with exercise or strong emotion. That type of arrhythmia is usually not cause for alarm. However arrhythmias that occur more often or accompany other heart problems may be more serious and should be discussed with your healthcare provider.Did you know it is estimated that on average, every forty seconds someone in the United States has a stroke, every year 55,000 more women than men have a stroke and every three to four minutes someone dies of a stroke?(According to American Heart Association’s computation based on the National Heart, Lung and Blood Institutes research) A Fib alone, can increase the risk of stroke by five fold.Atrial fibrillation (A-Fib), creates a disorganized electrical signal that causes a disturbance in the upper and lower chambers of the heart, preventing them from working together. With A Fib, instead of the body receiving a constant, regular amount of blood from the ventricles, it receives rapid, small amounts and occasional random, larger amounts, depending on how much blood has flowed from the atria to the ventricles with each beat. A-fib can affect both men and women, and is most common in older people.
4A-Fib Risk Factors Advancing Age Heart Disease High Blood Pressure Alcohol/Drug AbuseFamily HistoryCongenital Heart DisorderDiabetesSmokingObesityHigh Fat DietCertain Pre-scribed Med’sSedentary LifeStyleYour risk factors include:Age. The older you are, the greater your risk.Heart disease. If have been with heart disease, valve problems, Anyone with heart disease, including valve problems, history of heart attack and heart surgery, has an increased risk of atrial fibrillation.High blood pressure. Having high blood pressure, especially if it's not well controlled with lifestyle changes or medications, can increase your risk of atrial fibrillation.Other chronic conditions. People with thyroid problems, sleep apnea and other medical problems have an increased risk of atrial fibrillation.Drinking alcohol. For some people, drinking alcohol can trigger an episode of atrial fibrillation. Binge drinking — having five drinks in two hours for men, or four drinks for women — may put you at higher risk.Family history. An increased risk of atrial fibrillation runs in some families.To reduce your risk of developing an arrhythmia/A Fib or to slow its progression. Do:Drink plenty of waterEat a heart-healthy dietEliminate unnecessary stressExercise regularlyMaintain a healthy weightSee your doctor regularlyDon't:Smoke or expose yourself to second-hand smokeDrink excessive amounts of alcohol, caffeine, or sugary drinksIgnore your symptoms, which may signal heart problemsA Fib accounts for 15-20% of strokes in the U.S. totaling 105, ,000 strokes per year. (American Heart Association)If you find yourself at risk, work with your doctor to control your condition and lower your risk for complications.
5How is A-Fib Diagnosed? Cardiac Exam Holter Monitor Event Monitor EchocardiogramTransesophageal EchocardiogramBlood TestsThe doctor will do a complete cardiac exam, listening to the rate and rhythm of your heartbeat and taking yourpulse and blood pressure reading. The doctor will likely check to see whether you have any sign of problems withyour heart muscle or valves. He or she will listen to your lungs to check for signs of heart failure.An EKG is a simple test that detects and records the electrical activity of your heart. It is the most useful test fordiagnosing AF. It shows how fast the heart is beating and its rhythm (steady or irregular). It also records the timingof the electrical signals as they pass through each part of the heart.Holter Monitor- Also called an ambulatory EKG, this device records the electrical signals of the heart for a full 24- or48-hour period. You wear small patches called electrodes on your chest that are connected by wires to a small,portable recorder. The recorder can be clipped to a belt, kept in a pocket, or hung around your neck.Event monitors are useful to diagnose AF that occurs only once in a while. The device is worn continuously, but onlyrecords the heart’s electrical activity when you push a button. You push the button on the device when you feelsymptoms. Event monitors can be worn for 1 to 2 months, or as long as it takes to get a recording of the heartwhen symptoms are occurring.This test uses sound waves to create a moving picture of your heart. Anechocardiogram provides information aboutthe size and shape of your heart and how well your heart chambers and valves are functioning. The test also canidentify areas of poor blood flow to the heart, areas of heart muscle that aren’t contracting normally, and previousinjury to the heart muscle caused by poor blood flow.A transesophageal (trans-e-SOF-ah-ge-al) echocardiogram, or TEE, takes pictures of the heart through youresophagus (the tube leading from your mouth to your stomach). The atria are deep in the chest and often can’t beseen very well on a regular echocardiogram. A doctor can see the atria much better with a TEE. In this test, thetransducer is attached to the end of a flexible tube that’s guided down your throat and into your esophagus. TEE isusually done while the patient under some sedation. TEE is used to detect clots that may be developing in the atriabecause of AF.Blood tests. These tests check the level of thyroid hormone and the balance of your body’s electrolytes. Electrolytesare minerals in your blood and body fluids that are essential for normal health and functioning of your body’s cellsand organs.Once detected, there are 3 different types of A Fib:Paroxysmal (par-ok-SIZ-mal) A Fib is the abnormal electric signals and rapid heart rate begin suddenly and then stop on their own. Symptoms can be mild or severe and last for seconds, minutes, hours, or days.Persistent A Fib is a condition in which the abnormal heart rhythm continues until it’s stopped with treatment.Permanent A Fib is a condition in which the normal heart rhythm can’t be restored with the usual treatments. Both paroxysmal and persistent A Fib may become more frequent and eventually result in permanent A Fib.
6Start with Prevention!It is never too late or too early to take control of your healthBelow are some suggestions on how you can prevent A Fib and lead a healthy cardiovascular disease free life:Not smokingRegular physical activityMaintaining a healthy weightLimit alcohol intakeControl blood glucose(especially if you have diabetes)Regular check-up’sHeart healthy diet filled with low saturated fatty food, low trans fat and low cholesterolSpecific treatments for A Fib include:Blood Clot Prevention with use of warfarin (Coumadin), heparin and aspirinRate Control with use of beta blockers (ie: metoprolol and atenolol), calcium channel blockers (diltiazem and verapamil) and digitalis (digoxin)Rhythm Control with use of amiodarone, sotalol, flecainide, propafenone, dofetilide, ibutilide, and other older medications such as quinidine, procainamide and disopyramide.Medical Procedures used to treat A Fib:Electrical CardioversionRadiofrequency ablationMaze ProcedureIf A Fib is detected, there are treatments such as medicines, medical procedures or simple lifestyle changes that may be taken. Partner with your provider to discuss the best option for your condition.People who have A Fib can live normal, active lives!
7Know your next steps Research your family history Schedule a physical examTalk to your physician about your best option!