If your heart flutters, it might be more serious than you think.
The American Stroke Association reports 2.7 million people are living with atrial fibrillation (AFib), and many more don’t know they have it.
Atrial fibrillation is caused by an irregularity in the top part of the heart, or atrium. Instead of the atrium beating regularly, it quivers very quickly. The problem is it can lead to heart failure, blood clots or stroke.
AFib is not a terminal condition but it is more common than people think. The older we get, the more likely it will develop. Advances in technology to diagnose AFib is giving patients and physicians more options in how to manage it.
The first step in diagnosis is recording an AFib event. It’s important to first find out how frequent the patient feels fluttering in the heart. Based on what the patient tells me, we can choose the appropriate monitoring device.
If you have several heart fluttering episodes per day, we could use a short-term monitoring device. These devices are relatively small, attached to electrodes on the outside of the body and carried for one day up to two weeks.
This external monitor is a good option if the patient has two to three episodes daily. Along with wearing the monitors, we ask the patient to write down the time of the episode in an event diary. Later on, the diary helps the cardiologist narrow down the time frame of the episode when sifting through the recorded heart data.
If a patient has very infrequent episodes of AFib, a loop recorder could be a good option. It’s called a loop recorder because, as it records if no event is detected, it deletes the recording and records a new “loop” continuously. The loop recorder is implanted under the skin and is about the size of a USB thumb drive. Only one small incision is made to install it, and the battery can last up to three years. Even then it is possible no episode will be detected during those three years.
The loop recorder can be very convenient for the patient, because the device will electronically notify the cardiologist’s office if an event occurred. It has a wonderful ability to detect significant events as soon as they happen- if they happen.
Once AFib is detected, it’s important to eliminate reversible causes of it. Some of these causes are thyroid disease, alcohol consumption or sleep apnea, heart rhythm control, heart rate control and preventing blood clots with blood thinners. Blood thinner medications are prescribed, because they reduce the chances of having a stroke.
Which method is best to manage AFib is still up for some debate. Heart rhythm therapy involves attempting to restore the normal rhythm of the heart by delivering electrical shocks.
Radiofrequency ablation, or catheter ablation, involves inserting a catheter into a peripheral blood vessel and advancing it to the heart to eliminate the abnormal signals and restore normal rhythm. Even with ablation, there is no permanent, complete cure for AFib, but there is hope in minimizing it. The best-case scenario is you are able to maintain normal sinus rhythm.
AFib by itself doesn’t kill people. It’s very well tolerated by the body. Many patients don’t show any signs, also known as asymptomatic. They can live their entire life without having any problems.
Heart quivering or fluttering is the most common form of irregular heartbeat. If you think you might have atrial fibrillation, it’s important to contact your physician. If you experience chest pain or pressure, it might be a medical emergency. Call 911 immediately.
Dr. Sam Rahman is an interventional cardiologist at MUSC Health-Cardiology and is a member of the medical staff at MUSC Health-Florence Medical Center. He is accepting new patients. For more information, call 843-674-4787 or go to MUSChealth.org/florence.