Over the past several years.

Over the past several years, atrial fibrillation, the greatest in quantity common type of irregular heartbeat, has been increasingly recognized as a potentially serious condition. Physicians used to think it was a relatively harmless cardiac arrhythmia that didn't ne to be treated unles it caused symptoms or was associated with valvular heart disease.

But all that has changed. Atrial fibrillation (AF) is well known to be an independent risk factor for calamity and death. Indeed, stroke risk is increased more than fivefold in family with AF, and their attacks are nearly twice as likely to be fatal as those in the public without the rhythm abnormality.

AF has become an active area of research: a certain quantity of studies are comparing the efficacy of mix with drugs treatments that control heart verse or rate; others are evaluating the risks and benefits of electrical therapies and surgery

The condition affects about 2 million Americans, and its incidence rises with age. Although AF does fall out in middle-aged adults and a certain number of younger ones, it is out of the way Data from the Framingham Heart subject of attention indicate that 6.5% of family 50-59 have the condition and that the rate rises steadily to 31% in clan 80 and older.

A coordinated effort

When the heart is functioning suitably its four chambers beat in a well-orchestrated way. (The upper sum of two units chambers are called the right and left atria; the lower sum of two units are the right and left ventricles.) A chamber contracts, or beats, when triggered by means of an electrical impulse. This signal is generated at the sinus node, a small set off in a hurry of specialized cells in the wall of the right atrium.

In AF, the heart's electrical impulses secure out of whack. This causes the atria to quiver erratically instead of beating forcefully at a regular rate. As a come blood isn't pumped completely not at home of the atria, allowing it to puddle and clot. If a piece of a concretion breaks off and travels to an artery that supplys the brain, the blockage of descendants flow will likely cause a stroke

Unfortunately, rap is the leading cause of disability in the United States and the third mostly common cause of death. Although blows can be prevented, they usually cannot be treated. (For more forward stroke, see Harvard Health literal sense July 1998.) Indeed, stroke prevention is a vital component part of AF treatment.

The parent of the problem

Several conditions can trigger AF. The greatest in number common are high blood influence congestive heart failure, and prior heart attack. Other causes include valvular heart disease, an overactive thyroid, infections, and excessive alcohol consumption. Sometimes, doctors can find no apparent cause.

In chiefly cases of AF, a [i]role[/i] will experience such symptoms as heart palpitations, chest discomfort, shortness of breath, exercise intolerance, fatigue, or lightheadedness.

Although the condition is chronic for greatest in quantity people who have it, in an it occurs intermittently and is known as paroxysmal. This emblem is characterized by recurrent episodes that either unravel on their own or in replication to medical treatment. People with episodic palpitations are ofttimes asked to wear a portable heart monitor for 24 hours to document the duration and oftenness of the episodes.

Often, AF can travel on for hours or equable a day or two without causing harm; however, the risk of coagulates is highest when AF has not stopped upon its own or has gone untreated for 48 hours or more. Evidence hints that many people with intermittent AF will eventually bring out the chronic form.

Treating it right

There are three goals in treating AF: slowing the heart rate, preventing [i]crassamentum[/i]s and strokes, and restoring a normal heart periodical emphasis when possible. Digoxin is generally used to deliberate the heart rate either alone or in combination with other medicines such as beta-blockers (propranolol, atenolol) or calcium channel blocker (verapamil).

Although these medications cut short discomfort in many people, they may have side efficiencys and they do not diminish stroke risk. Long-term use of warfarin (Coumadin), an anticoagulant, has been shown to stop up to 80% of pats in people with AF, moreover there is evidence that the medication is underused. A application of mind published last year in the journal visitation found that of 272 patients with AF, single 38% were receiving warfarin. Many master-hands believe that the majority of race with AF should be taking the anti-clotting mix with drugs Aspirin, which also prevents concretes is far less effective than warfarin on the contrary is sometimes used when the risk of hardship is very low.

Some doctors have been hesitant to prescribe warfarin because it increases the risk for bleeding complications. Increased bleeding from a nick or a chop may be inconsequential, but if it originates from a stomach ulcer or serious fall, for example, it could be life-threatening. Unfortunately, warfarin use is oftentimes seen by both doctors and patients as an inconvenience because the public who take the medication must procure periodic blood tests so that the physician can monitor and adjust the dose to maintain it at a safe level

Although testing may be a bit of a nuisance and bleeding moot points are a possibility, experts do not consider these proper enough reasons for anyone at high risk for thump to forego warfarin. Someone defined as high risk has AF and more than common additional risk factor for thump such as congestive heart failure, a history of hypertension, previous rap or blood clots. A individual at moderate risk may have AF and common additional risk factor; people in this category should weigh the pro and consider minutelys of warfarin use with their physician. In a certain quantity of cases, aspirin may be the physic of choice. Those at reasonable risk, who have AF further no other risk factors for attack are the best candidates for aspirin therapy.