Atrial Fibrillation is a common cardiac dysrhythmia. Normally the top part of the heart, the atria, which serve as the receiving pumps of the heart, contract and squeeze the blood down into the ventricles before the atrioventricular valves shut and the ventricles pump the blood out of the heart and into the lungs and body. The contraction is caused by electrical activity in the muscle of the heart. It originates in one area and uniformly spreads throughout the walls of the heart creating an even and effective contraction. If the electrical activity becomes chaotic the atrial walls simply twitch randomly, producing a resemblance to a bag of worms. Because the main natural pacemaker of the heart lies within the atrial walls, the rhythm will now be totally irregular.

This can be a transient or a chronic condition. While some people have no symptoms, many will experience palpitations, the sensation of feeling their heart pounding. Due to a loss of the atrial contraction to help fill the ventricles before they contract there is an approximate loss of 10% cardiac output, the amount of blood pumped out of the heart. This can also cause symptoms of weakness and fatigue. Since the rhythm is now irregular it can be bradycardic or slow, below 60 beats per minute, or tachycardic or fast, greater than 100 beats per minute. It can also alternate between slow and fast abruptly.

Diagnosis of this and most arrhythmias are achieved by monitoring the heart rhythm. This can be done with 12 lead electrocardiograph (EKG), in-hospital telemetry, ambulatory 24 hour holter monitoring or 30 day event monitoring. This will provide the documentation needed to treat the atrial fibrillation.

When atrial fibrillation is first observed it can sometimes be converted back to normal sinus rhythm with medications or a cardioversion with external shocks. There are some pharmaceuticals that, taken regularly, can help to prevent atrial fibrillation from reoccurring. If atrial fibrillation becomes a chronic condition that cannot be alleviated by these treatments, steps are taken to help make the condition easier and safer to live with. Atrial fibrillation clients should be treated with blood thinner unless there is a contraindication present, such as bleeding ulcers or a history of stroke. The atrium now is unable to clear the out blood with each stroke and therefore the blood pools and poses a hazard for forming blood clots. Should a blood clot form, it could easily travel to the lungs, causing a pulmonary embolism, or to the brain, causing a stroke; each causing a potentially debilitating, even fatal situation.

It is necessary to keep the heart rate from racing as this can also cause lowered cardiac output due to less filling time for each stroke. This can be achieved by either pharmaceuticals or and ablation. An ablation will be completed by an electrophysiology cardiologist in a hospital cardiac Catheterization Laboratory. During the procedure the cells or pathways causing the fast heart rate are identified and destroyed.

ccasionally a pacemaker will now be necessary to keep the heart rate from going to slow.

So, although atrial fibrillation is common it is also to be treated with serious consideration. Many people live normal lives while in atrial fibrillation once the symptoms are alleviated and the risks are minimized.

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Author's Bio: 

I have worked to Sioux Valley Hospital, currently Sanford Health, since August 1981. I started working in Cardiovascular Services in 1986 doing exercise testing, holter monitor scanning, scoring pneumograms, performing and editing EKGs.

In 1987 I completed national testing to obtain my Certified Cardiograghic Technician status, achieving the number one score in the nation at the time of my testing. I have since maintained my CCT active status by compiling the necessary credits on an annual basis.

After my certification I became the Education Coordinator as well as Exercise Testing Team Leader teaching arrhythmias to new CVS technicians while managing the 11 employee Stress Lab.

As Education Coordinator I was required to write a bi-monthly newsletter to be sent to our many outreach clinics, teaching interpretation of arrhythmias.

During that time I also assisted in pacemaker implantation procedures by operating the x-ray unit for lead placement.

August 1998 I started working with teletrace doing transtelephonic event monitoring and Pacemaker testing. We schedule and receive event monitor recordings and pacemaker checks over the phone, interpret them and distribute them to the ordering physicians. We follow about 1600 pacemaker clients and have about 50 event monitors.