diagnosing AFib | Dr Raghu

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Atrial fibrillation is a progressive heart disease that can’t be cured. But the right course of treatment can help control afib symptoms and help patients live a close-to-normal life.

If you want to learn more about diagnosing atrial fibrillation, check out our previous blog posts.

Advancements in medical research have led to the development of different treatments for atrial fibrillation. Typically, you can choose from two treatment options – heart rate control and heart rhythm control.

Let’s take a look at the available treatment options and help you choose the right one.

Afib Treatment: Controlling Heart Rate

Rate control is an effective afib treatment option that involves controlling abnormal electrical activity in the atria to slow down the heart. This can be achieved with the help of medications or a surgical procedure.

Medications for Rate Control

Rate control medications slow down the conduction of electrical signals in the heart to prevent it from beating faster. These include:

  • Beta-blockers like atenolol (Tenormin), bisoprolol (Concor), carvedilol (Cardivas), metoprolol (Lopressor, Toprol), etc.
  • Calcium-channel blockers like diltiazem (Dilzem) and verapamil (Calaptin)
  • Digoxin (Lanoxin)

Beta-blockers and calcium-channel blockers (CCBs) are more widely used. However, they can cause side effects, such as headaches and dizziness.

Digoxin is prescribed to patients who can’t take beta-blockers or CCBs. Potential side effects include anxiety, mood swings, dizziness, nausea, and vomiting.

Irrespective of the type of medication you take, it can take time to identify the correct dosage. Also, your doctor might ask you to wear a Holter monitor to understand whether the medication is working.

AV Ablation

If rate control medications don’t work for a patient, they can undergo a procedure called AV ablation. It involves destroying cells in the atrioventricular node in the right atrium and installing a pacemaker to stabilize the heart rate.

Afib Treatment: Controlling Heart Rhythm

If afib symptoms, such as dizziness and fatigue, disrupt your normal life, your doctor might recommend treatment options to control the heart rhythm. However, it’s worth noting that it involves more serious side effects and risks.

The most commonly used rhythm control treatments for afib include:

Antiarrhythmics

Antiarrhythmics are medications that help the heart maintain its normal rhythm. These include:

  • Amiodarone (Cordarone)
  • Disopyramide (Norpace)
  • Dronedarone (Multaq)
  • Flecainide (Tambocor)
  • Propafenone (Rythmonorm)
  • Sotalol (Sotagard)

Cardioversion

Cardioversion is a medical procedure that restores the heart’s normal sinus rhythm using electrical impulses or antiarrhythmic medications. Electrical cardioversion initially works for 90% of patients. Doctors often recommend rhythm control medications after the procedure to keep the heart’s rhythm in check.

It’s worth noting that cardioversion increases your risk of stroke. So, you might have to take anticoagulants for a month before and after the procedure.

Catheter Ablation

Catheter ablation is a minimally invasive procedure that controls an abnormal heart rhythm by destroying tiny spots of tissues in the atrium. It involves the use of heat (radiofrequency ablation) or cold(cryoablation).

Risks and complications of catheter ablation include stroke, heart attack, damage to blood vessels, and fluid buildup around the heart.

Choosing the Right Treatment

Your choice of afib treatment depends on various factors, including your age and how long you’ve had afib. For instance, if you’re young and have been newly diagnosed, cardioversion or catheter ablation might deliver better results. Rhythm control treatment is also essential for patients who experience severe symptoms.

On the other hand, if you’re older and don’t experience significant symptoms, such as dizziness, palpitation, and fatigue, rate control treatment might be better suited for you.

In Conclusion

Treating atrial fibrillation involves controlling the heart’s rate and rhythm to minimize bothersome symptoms. If you’ve been experiencing frequent afib episodes, consult your doctor right away to explore your treatment options.

Dr. C Raghu is a renowned cardiologist with more than two decades of experience. If you’ve been diagnosed with atrial fibrillation, reach out to Dr. Raghu today to choose the right treatment plan for your condition.

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    Atrial Fibrillation Treatment: Choosing a Long-Term Strategy and Controlling Heart Rate and Rhythm Blog

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      Atrial-fibrilliation-and-stroke.jpg

      Atrial fibrillation (AFib) interferes with the normal functioning of the heart. It can lead to blood clots, which, in turn, can result in a stroke or heart failure. That makes it crucial to diagnose the condition early on and start the necessary treatment.

      If you have been experiencing symptoms like palpitations, dizziness, fatigue, and shortness of breath, it’s important to consult a medical practitioner.

      What to Expect When You Visit a Doctor?

      If you think you’re at risk of developing AFib or already have the condition, your doctor will ask you about your medical history and symptoms. It’s a good idea to maintain a list of any unusual symptoms you might have been experiencing. If you have pre-existing medical conditions, such as hypertension, coronary artery disease, congestive heart failure, and diabetes, make sure you let the doctor know.

      Additionally, the doctor might ask questions about your family history and lifestyle. Once they have the necessary information, they’ll order one or more of the following tests before diagnosing AFib.

      Blood Tests

      These include tests to check your kidney, liver, and thyroid function. They’ll help identify underlying conditions, like hyperthyroidism, that might be causing afib episodes. Also, they’ll help your doctor decide the right course of AFib treatment.

      Periodic ECG especially during palpitations is immensely helpful to diagnose AFib.

      Chest X-Ray

      It’ll help identify conditions, such as COPD and heart failure, that could be causing AFib.

      Electrocardiogram (ECG)

      It helps monitor the heart’s electrical activity and detect any abnormalities in the heart rate and rhythm.

      Exercise Stress Test

      It involves undergoing an ECG while exercising on a treadmill or stationary bicycle. It helps identify conditions like coronary artery disease.

      Echocardiogram (Echo)

      It generates detailed images of the heart’s structure and movement to help doctors identify faulty valves and other defects.

      Long-term ECG monitoring devices introduced in recent times for the diagnosis of infrequent brief episodes of AFib

      Portable Heart beat Monitoring

      Your doctor might ask you to wear a portable device, like a Holter monitor or cardiac event recorder, to monitor brief and infrequent AFib episodes.

      If you don’t have any noticeable symptoms but are worried that you might be at risk of developing afib in the future, you can talk to your doctor about getting screened for the condition.

      Stroke is a debilitating consequence of AFib. People who benefit from anticoagulants can be identified by CHA2DS2-VASc score.

      Stroke Prevention and Atrial Fibrillation

      Experts believe that AFib is responsible for at least 20% of all strokes. Also, it can increase your risk of having a stroke by up to five times. If you’ve been diagnosed with the condition, it’s crucial that you talk to your doctor about stroke prevention.

      Risk Assessment

      The first thing a doctor will do is evaluate your risk of stroke. They calculate the CHA2DS2-VASc score, which is an acronym for:

      • C: Congestive heart failure
      • H: High blood pressure
      • A: Age 75 and older
      • D: Diabetes
      • S: Previous stroke
      • V: Vascular disease
      • A: Age 65 to 74
      • Sc: Sex

      Anticoagulant Medications

      Depending on your score, the doctor might prescribe anticoagulants or blood thinners to prevent the formation of blood clots. While warfarin used to be the most commonly used anticoagulant, doctors now prescribe other drugs like:

      • Apixaban (Eliquis)
      • Dabigatran (Pradaxa)
      • Rivaroxaban (Xarelto)

      Surgery

      If you can’t take blood thinner due to any medical condition, you can undergo a procedure called left atrial appendage closure to minimize your risk of stroke due to AFib.

      Timely diagnosis and proper treatment can improve the quality of life and longevity of individuals with AFib. If you experience any symptoms of AFib, make sure you immediately consult a doctor.

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