Three ways to manage atrial fibrillation

Article Date: Feb 2, 2013

Luis Couchonnal, M.D.Some people have no sense that they may be experiencing an arrhythmia, also known as abnormal heart rhythm. Others will experience arrhythmias with symptoms such as palpitations, shortness of breath or fatigue. These symptoms may all be signs of an abnormal heart rhythm known as atrial fibrillation (Afib).

Up to 5 million people in the United States suffer from Afib, one of the most common heart rhythm disturbances. However, about 25 percent of them will not realize they have Afib until it is uncovered by an electrocardiogram (EKG), says electrophysiologist Luis Couchonnal, M.D., of Alegent Creighton Clinic Heart & Vascular Specialists.

With Afib, the upper chambers of the heart beat irregularly and rapidly – at 300 beats per minute – and out of coordination with the two lower chambers of the heart. This causes poor blood flow to the body, resulting in symptoms such as fatigue and shortness of breath.

"People can live with Afib for years, but if not discovered and treated medically, it could result in stroke or weakening of the heart that can further result in congestive heart failure," said Dr. Couchonnal, who spoke at the recent Heart Healthy Cooking event at Alegent Creighton Health Lakeside Hospital.

Your physician’s goals for managing atrial fibrillation include:

  1. Stroke prevention – Most Afib patients have a five-times-greater risk of having a stroke than the rest of the population, said Dr. Couchonnal.

  2. Prevent heart failure – Uncontrolled rapid heart rhythm can weaken heart muscle functioning and lead to fatigue and irreversible damage down the line, he said.

  3. Minimize symptoms related to Afib – Physicians work to restore and maintain the normal heart rhythm with either medications or an invasive procedure known as a catheter ablation. The goal of the ablation procedure is to eliminate abnormal Afib "triggers" that typically occur within the left atrium that result in Afib.
The best ways to diagnose Afib is with an EKG, or long-term event monitor. While an EKG records the heart's electrical impulses (heart beats) and is performed in the doctor’s office, an event monitor is a device worn by patients for up to 30 days that records Afib episodes.

The risk of developing Afib increases with age, especially after age 60. Other risk factors include: obesity, uncontrolled hypertension, heart disease (including heart attacks, heart failure and heart valve disease), excessive alcohol use, overactive thyroid, obstructive sleep apnea or lung disease (emphysema or COPD).

"If atrial fibrillation is due to obesity, hypertension, alcohol use, overactive thyroid or obstructive sleep apnea, those are things you can do something about," said Dr. Couchonnal. "In that case, Afib is potentially reversible."


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Luis Couchonnal, M.D.

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