Hello welcome everybody, this is Bolad, board certified physician in cardiology interventional
cardiology and internal medicine. I am here to help you with all the information you need
for your heart health and medical health and informing you about all the latest treatments
in cardiology and medicine. If you are new to this channel and would like to take great care of your
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you don't miss any up-to-date information that emerges in cardiology and the medical field. Also,
click on the notification bell so you are aware of new videos that I upload. Today I will be talking
to you about atrial fibrillation, a very common disorder in the heart rhythm as this can have
significant long-term complications, so let's get started to learn about atrial fibrillation.
What is atrial fibrillation? Atrial fibrillation is also known as AFib or AF for short,
is the most common abnormality in heart rhythm in which the heartbeat is completely irregular. This
is how it looks in the heart monitor. As you can see on the left side of the screen normally the
heartbeat originates in the right upper chamber of the heart and the electrical activity travels down
to the lower chambers, leading to contraction with resultant pumping of blood to the lungs on the
body. In atrial fibrillation as shown on the right side of the screen, irregular heartbeat originates
from the left upper chamber of the heart and it is completely irregular and generally fast. This
pattern of heartbeat has serious complications. Firstly, clot formation in the heart and this
is due to inefficiency of the blood circulating through the heart and stagnation of blood in the
left upper part of the heart, particularly in a part known as the left atrial appendage. As seen
in here the clot can then move through the heart and it can go up artery to the brain and it will
block flow to the brain leading to a stroke. This is obviously a very serious complication.
Secondly weakening of the muscle of the heart as atrial fibrillation can lead to fast heart rate
the heart tends to weaken and reduce its pumping ability as it cannot cope with the fast heart rate
for long periods of time. This can lead to heart failure. This is shown in this echocardiogram
and can be appreciated that the heart contraction is weak and heart is in a state of heart failure.
Thirdly, there is an increased incidence of death in patients with atrial fibrillation
compared to those without atrial fibrillation. So what is the prevalence of atrial fibrillation?
Atrial fibrillations tend to be more prevalent in older age, the prevalence of atrial fibrillation
increases with age. The overall problems of atrial fibrillation across all age groups is
about one percent. However the prevalence is 0.1 percent among adults less than 55 years of age
but increases sharply to about 10 percent in those 80 years of age and older.
Gender, the prevalence of atrial fibrillation in higher in men than women. Race,
atrial fibrillation is more frequent in whites than blacks over the age of 50 years.
Geography, the prevalence rate per hundred thousand population is highest in North
America and lowest in Japan and South Korea. The next question would be is there an association
with other diseases, the answer is yes atrial fibrillation occurs more with higher incidence
in patients with, high blood pressure affecting the heart, coronary artery disease,
Valve heart disease especially the mitral valve and those who suffered from rheumatic
heart disease, Heart Failure in which the contraction of the heart is weak,
Hypertrophic Cardiomyopathy in which the muscle wall between the lower chambers
of the heart thickened leading to obstruction of flow of blood to the Aorta, obstructive sleep
apnea which is an issue with air flow in the lungs when the patient sleeps,
obesity, diabetes,
chronic kidney disease.
You might ask how do physicians evaluate atrial fibrillation? If atrial fibrillation is suspected,
your doctor will need to perform history and physical examination
to diagnose the atrial fibrillation and look for associated factors,
get an electrocardiogram to document the irregular heartbeat as shown here,
get an ultrasound scan of the heart known as echocardiogram to evaluate
the size of the heart chambers to detect possible valvular heart disease, sometimes
we perform a transphosphere echocardiogram similar to performing an endoscopy procedure
to look at the heart from behind to look for clots forming in the upper left part of the heart,
request blood tests especially looking for thyroid function and electrolyte abnormalities.
How do we treat atrial fibrillation? There are different aspects for the treatment of patients
with atrial fibrillation, these include blood thinners this is aimed to prevent blood clotting
in the heart and avoid the risk of strokes from those clots forming in the heart. All patients
with atrial fibrillation should receive blood thinners. There are a variety of blood thinners
available and these include warfarin and other newer medications such as dagibatran and apixiban.
Control of the heart rate associated with atrial fibrillation in order to prevent
weakening of the heart muscle and prevent the development of
heart failure. Putting the heart back to its normal pattern, this can be achieved by
medications to convert the pattern of beating from atrial fibrillation to normal regular beating.
Alternatively electric shock by a procedure turn DC cardioversion
after the patient has been anesthetized so as not to feel the electric shock.
If the above fail in putting the heart rhythm back to normal then we can perform a procedure
known as atrial fibrillation ablation. Catheters are inserted through the veins in the leg all
the way to the upper left side of the heart and isolates the tissue responsible for generating
the abnormal electrical activity leading to the atrial fibrillation. This is done by applying
heat through the catheter tips and has a high success rate in correcting the abnormality.
If you have any question about what I presented to you today or any cardio question in general
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then please follow me on twitter @DoctorBolad and then you can send me a direct message and I will
certainly reply to you. Again this is Dr Bolad helping you with your heart health and beyond,
thanks for watching and talk to you soon.