How is atrial fibrillation diagnosed. What tests are used to detect AFib. Can blood tests help in diagnosing atrial fibrillation. What role do electrocardiograms play in AFib detection. Are there any new technologies for AFib diagnosis.

Understanding Atrial Fibrillation: Symptoms and Initial Diagnosis

Atrial fibrillation (AFib) is a complex heart rhythm disorder that may or may not present noticeable symptoms. Some individuals might discover they have AFib during a routine physical examination, while others may seek medical attention due to specific symptoms. Common signs that might prompt a visit to the doctor include:

• A fluttering sensation in the chest
• Unexplained fatigue
• Irregular heartbeat
• Shortness of breath
• Dizziness or lightheadedness

When suspecting AFib, a healthcare provider will typically begin with a thorough physical examination. During this initial assessment, the doctor will listen to the heart using a stethoscope, aiming to detect any irregularities in the heartbeat. However, it’s important to note that not all cases of AFib can be diagnosed through auscultation alone, necessitating further diagnostic tests.

The Role of Specialists in AFib Diagnosis

While a primary care physician might be the first to suspect AFib, the complexity of the condition often requires the expertise of specialists. Patients may be referred to:

• Cardiologists: These specialists focus on heart diseases and conditions
• Electrophysiologists: Doctors who specialize in heart rhythm disorders

These specialists bring advanced knowledge and experience in diagnosing and treating AFib, ensuring patients receive comprehensive care tailored to their specific situation.

Essential Diagnostic Tests for Atrial Fibrillation

Diagnosing AFib often requires a combination of tests to confirm the condition, identify its underlying causes, and determine the most effective treatment approach. Here are some of the key diagnostic tools used in AFib detection:

Electrocardiogram (ECG or EKG): The Gold Standard

An electrocardiogram is considered the most valuable test for diagnosing AFib. This non-invasive procedure records the heart’s electrical activity, providing crucial information about:

• Heart rate
• Heart rhythm
• Strength and timing of electrical signals in the heart

During an ECG, small patches called electrodes are placed on various parts of the body, primarily the chest. These electrodes detect electrical signals, which are then translated into wave patterns on the ECG results. This gives doctors a comprehensive picture of the heart’s overall electrical activity.

Do ECGs always detect AFib? While ECGs are highly effective, they provide a snapshot of the heart’s activity at a specific moment. As AFib can be intermittent, a standard ECG might not always capture the arrhythmia. In such cases, additional monitoring methods may be necessary.

Holter Monitor: Extended Heart Rhythm Monitoring

A Holter monitor is a portable device that continuously records the heart’s electrical activity over an extended period, typically 24 to 48 hours. This prolonged monitoring increases the chances of detecting irregular heart rhythms that might not appear during a standard ECG.

How does a Holter monitor work? Similar to an ECG, small electrodes are attached to the chest. These are connected to a small recorder that can be easily carried or worn. Patients go about their daily activities while the device records their heart’s activity, providing a more comprehensive view of their heart rhythm over time.

Event Monitor: Capturing Intermittent Symptoms

An event monitor is another portable device used for longer-term heart rhythm monitoring, usually over a 30-day period. Unlike the Holter monitor, which records continuously, an event monitor captures heart activity only at certain times.

When is an event monitor used? This device is particularly useful for patients who experience intermittent symptoms. It can be set to automatically start recording when it detects an irregularity, or patients can manually activate it when they feel symptoms such as dizziness, weakness, or heart palpitations.

Advanced Diagnostic Techniques for Atrial Fibrillation

As medical technology advances, new and more sophisticated methods for diagnosing AFib have emerged. These techniques offer enhanced accuracy and convenience for both patients and healthcare providers.

Mobile Cardiac Telemetry (MCT): Continuous Remote Monitoring

Mobile Cardiac Telemetry represents a significant advancement in heart rhythm monitoring. This small, wearable device provides 24/7 monitoring of the heart’s activity as patients go about their daily lives.

How does MCT differ from other monitoring methods? MCT devices typically use Bluetooth technology to transmit data to a central monitoring station. This real-time data transmission allows for immediate analysis and reporting to the patient’s doctor, enabling quicker response to any detected abnormalities.

Stress Test: Assessing Heart Function Under Exertion

A stress test, also known as an exercise stress test or treadmill test, evaluates how the heart responds to physical exertion. This test can be particularly useful in diagnosing AFib that occurs or worsens during physical activity.

What happens during a stress test? Patients are connected to an ECG machine and their blood pressure is monitored while they exercise, typically on a treadmill or stationary bicycle. For those unable to exercise, medication can be used to simulate the effects of physical exertion on the heart.

Echocardiogram: Visualizing Heart Structure and Function

An echocardiogram uses sound waves to create a detailed moving picture of the heart. This non-invasive imaging technique provides valuable information about:

• The size and shape of the heart
• The functioning of heart muscles and valves
• Areas of abnormal heart muscle contraction

What types of echocardiograms are used in AFib diagnosis? The most common type is the transthoracic echocardiogram (TTE), where a transducer is moved over the chest to capture images of the heart. In some cases, a transesophageal echocardiogram (TEE) may be necessary, which involves inserting a probe down the esophagus to obtain clearer images of the heart’s structure.

The Role of Blood Tests in Atrial Fibrillation Diagnosis

While not directly diagnostic for AFib, blood tests play a crucial role in the overall assessment of patients suspected of having this condition. These tests can provide valuable information about underlying health issues that may contribute to or complicate AFib.

Key Blood Tests in AFib Evaluation

Several blood tests are commonly performed as part of the diagnostic process for AFib:

• Complete Blood Count (CBC): Checks for anemia or infections that might affect heart function
• Thyroid Function Tests: Assesses thyroid hormone levels, as thyroid disorders can trigger AFib
• Electrolyte Panel: Measures levels of important minerals like potassium and magnesium, which influence heart rhythm
• Kidney Function Tests: Evaluates kidney health, which can impact fluid balance and heart function
• Liver Function Tests: Assesses liver health, which can affect medication metabolism

Can blood tests diagnose AFib directly? While blood tests cannot definitively diagnose AFib, they are essential for identifying underlying conditions that may contribute to its development or affect its treatment. They also help in assessing overall health status and guiding treatment decisions.

Emerging Technologies in AFib Detection

The field of AFib diagnosis is rapidly evolving, with new technologies offering promising advancements in early detection and continuous monitoring.

Portable Electrocardiogram Devices

Portable ECG devices have revolutionized the way patients can monitor their heart rhythms. These compact devices, often no larger than a credit card, allow users to record their ECG at any time and in any place.

How do portable ECG devices work? Users typically place their fingers on small sensors on the device, which then records a short ECG. Some devices can transmit this data directly to a smartphone app or to a healthcare provider for analysis.

Fitness Trackers and Smartwatches

Many modern fitness trackers and smartwatches now include heart rate monitoring features, with some advanced models capable of detecting irregular heart rhythms that may indicate AFib.

Are these consumer devices reliable for AFib detection? While these devices can be useful for initial detection, it’s important to note that they are not medical-grade equipment. Any irregularities detected by these devices should be followed up with a healthcare provider for proper diagnosis.

Implantable Cardiac Monitors

For patients with infrequent symptoms or those at high risk of AFib, implantable cardiac monitors offer a long-term solution for heart rhythm tracking. These small devices are placed under the skin in a minimally invasive procedure and can continuously monitor heart rhythm for up to several years.

What are the advantages of implantable monitors? These devices provide continuous, long-term monitoring without the need for external wires or patches. They can detect even brief or asymptomatic episodes of AFib, providing valuable data for diagnosis and treatment planning.

Comprehensive Approach to AFib Diagnosis

Diagnosing atrial fibrillation often requires a multifaceted approach, combining various diagnostic tools and techniques to obtain a clear picture of the patient’s heart health.

Electrophysiology Study: In-Depth Heart Rhythm Analysis

In some cases, an electrophysiology study may be necessary to fully understand the nature of a patient’s arrhythmia. This invasive procedure involves inserting catheters into blood vessels and guiding them to the heart to record electrical activity from within the heart chambers.

When is an electrophysiology study recommended? This test is typically reserved for complex cases where the cause of arrhythmia is unclear or when planning certain treatments, such as catheter ablation.

Importance of Patient History and Symptom Analysis

While advanced diagnostic tools are crucial, the importance of a thorough patient history and symptom analysis cannot be overstated. Healthcare providers rely heavily on patients’ descriptions of their symptoms, including:

• The nature and frequency of symptoms
• Triggers that seem to bring on symptoms
• Any family history of heart conditions
• Lifestyle factors that might contribute to heart rhythm issues

How can patients prepare for their diagnostic appointment? It’s helpful for patients to keep a detailed log of their symptoms, including when they occur and what activities or situations might be associated with them. This information can be invaluable in guiding the diagnostic process.

Challenges in AFib Diagnosis and Future Directions

Despite advancements in diagnostic technologies, diagnosing AFib can still present challenges, particularly in cases of paroxysmal (intermittent) AFib or when symptoms are subtle or absent.

Addressing Diagnostic Challenges

Some of the ongoing challenges in AFib diagnosis include:

• Detecting brief or asymptomatic episodes
• Distinguishing AFib from other arrhythmias
• Identifying the underlying causes of AFib
• Managing the increasing volume of data from long-term monitoring devices

How are these challenges being addressed? Ongoing research is focused on developing more sensitive and specific diagnostic tools, improving algorithms for analyzing heart rhythm data, and integrating artificial intelligence to assist in interpreting complex cardiac information.

Future Directions in AFib Diagnosis

The future of AFib diagnosis looks promising, with several exciting developments on the horizon:

• Advanced wearable technologies with improved accuracy and longer battery life
• Integration of AFib detection into everyday devices like smartphones and smart home systems
• Development of blood-based biomarkers specific to AFib
• Improved imaging techniques for visualizing structural heart changes associated with AFib

What impact will these advancements have on AFib management? These developments are expected to lead to earlier detection of AFib, more personalized treatment approaches, and improved long-term outcomes for patients with this condition.

In conclusion, the diagnosis of atrial fibrillation involves a comprehensive approach, utilizing a range of tools from traditional methods like ECGs to cutting-edge technologies like implantable monitors. As our understanding of AFib grows and technology continues to advance, we can expect even more precise and patient-friendly diagnostic methods to emerge, ultimately leading to better management and outcomes for individuals affected by this common heart rhythm disorder.

Tests used to Diagnose Afib

Written by WebMD Editorial Contributors

• Doctor Exam
• Does AFib Show Up on an Electrocardiogram (EKG)?
• Holter Monitor
• Event Monitor
• Mobile Cardiac Telemetry (MCT)
• Stress Test
• Echocardiogram
• Blood Tests
• Portable Electrocardiogram
• Fitness Trackers
• Electrophysiology Study
• More

Atrial fibrillation, or AFib, may or may not cause symptoms. Your doctor could find it during a regular physical. Or you might make an appointment after you notice signs like a fluttering heartbeat or fatigue.

If your doctor thinks you have it, the first thing they’ll do is listen to your heart. They may be able to hear your irregular heartbeat with a stethoscope. If not, they may ask for tests to confirm the diagnosis, find out what’s causing it, and figure out the best way to treat it.

Sometimes your primary care or family doctor is the one who diagnoses AFib. But your doctor may refer you to a:

• Cardiologist, a doctor who specializes in heart diseases and conditions
• Electrophysiologist, a doctor who specializes in arrhythmias

When you make an appointment with your doctor or the specialist to see if you might have atrial fibrillation, ask if you need to do anything to prepare. You may need to follow a special diet before blood tests, for example.

To make the most of your time with the doctor, be ready to describe your symptoms and when they happen. Make a list of medications you take, including supplements and over-the-counter medicines. And be prepared with information about your health history and that of close family members.

Take note of any questions you have for your doctor, such as:

• What could be causing my symptoms?
• What kind of tests will I need?
• What are the recommended treatments for my condition? Are there any effective alternatives?
• Do I need to make changes to my lifestyle?

During your exam, the doctor will ask detailed questions about your:

• Symptoms
• Health habits
• Health problems
• Family medical history

During the physical exam, they are likely to:

• Listen to your heartbeat’s rate and rhythm
• Take your pulse and blood pressure
• Listen to your lungs

Yes. This simple, painless test is the most helpful to diagnose AFib. It records your heart’s electrical activity. It can show the:

• Speed of your heartbeat
• Rhythm of your heartbeat
• Strength and timing of electrical signals passing through your heart

A doctor or technician places small patches, called electrodes, on different areas of your body, including several on your chest. These pick-up signals that make wave patterns on the EKG results. It gives your doctor a picture of your heart’s overall electrical activity.

But because the test is a quick snapshot, a standard EKG won’t always catch AFib. Sometimes you’ll need a portable heart rhythm monitor to keep tabs on your ticker over a longer time.

You keep this device with you for 24 to 48 hours while it continuously records your heart’s electrical activity. The extra time gives a better chance of picking up an abnormal heart rhythm, what doctors call an arrhythmia.

Just as with a regular EKG, you’ll have small electrodes attached to your chest. Wires connect these electrodes to a small recorder you can clip onto a belt, keep in a pocket, or hang around your neck.

Then you just go about doing what you usually do. Your doctor will check the recorded results later.

This works like a Holter monitor, but it records your heart’s activity only at certain times, usually for a 30-day period. It might automatically start recording when it senses something is off. Or you might have to push a button when you feel:

• Dizzy
• Weak
• Lightheaded
• A racing or fluttering heart

You may need to wear it for a month or so — as long as it takes to catch and record the trouble.

You might hear this called mobile cardiac monitoring. You wear this small device 24/7, and it monitors your heart as you go about your daily life. Most send a Bluetooth signal to a data center, which analyzes the info and gives your doctor a report.

It’s just what it sounds like: A test that puts extra stress on your heart to see how it responds to working hard and beating fast. You’ll be hooked up to an EKG during the test, and the technician will watch your heart rate and blood pressure, too.

Exercise is an easy way to get your heart pumping. You might ride a stationary bicycle, or walk or run on a treadmill. That’s why this is sometimes called a treadmill test.

If your body can’t handle intense activity, you can take a special medicine that makes your heart beat faster instead.

This test uses sound waves and a computer to create a moving picture of your heart. An echo gives your doctor information about:

• The size and shape of your heart
• How well the heart muscle and valves are working
• Where the heart muscle isn’t contracting the right way

Transthoracic echocardiogram (TTE). This imaging test gives your doctor a picture of your heart. The doctor uses a device called an ultrasound transducer to give off and read sound waves that bounce off the walls and valves in your heart. A computer uses the data to create a video of your heart. Your doctor can see the size of your heart, how well it’s working, how well your heart valves are working, and if you have any blood clots.

Transesophageal echocardiogram (TEE). This imaging test gives the doctor a picture of your heart. They’ll place a probe down your esophagus (the tube that connects your mouth to your stomach). It goes right behind your heart. Once the probe is in place, it works the same way as a TTE.

These can point your doctor to what might be causing your AFib. Blood tests may check for infection, thyroid and kidney problems, signs of a heart attack, and more.

You might hear this called a handheld EKG. Or it could look like a wristwatch. It has electrodes on the back that take your pulse at your chest or your wrist. You can get one from a discount store, drugstore, or online. The doctor may suggest you do it so you can take a quick reading when you feel something. It’ll store your EKG data in its memory for your doctor to read.

Popular smartwatches outfitted with special sensors called photoplethysmographic sensors (or PPGs) can detect AFib.

An electrophysiology study (EPS) can help your doctor understand what’s causing your abnormal heartbeat and figure out the best way to treat it.

In this operation, your cardiologist inserts a thin, flexible electrode into a blood vessel leading to your heart, usually in your neck or groin. They then use an imaging system to guide the electrode to your heart. Once there, the electrode can measure your heart’s electrical signals.

Your doctor will give you a numbing medication before the surgery to keep you from feeling pain. You might also get a sedative to help relax you. The procedure may take 1-4 hours, and you’ll rest in a recovery room for 4-6 hours after that.

Top Picks

Tests used to Diagnose Afib

Written by WebMD Editorial Contributors

• Doctor Exam
• Does AFib Show Up on an Electrocardiogram (EKG)?
• Holter Monitor
• Event Monitor
• Mobile Cardiac Telemetry (MCT)
• Stress Test
• Echocardiogram
• Blood Tests
• Portable Electrocardiogram
• Fitness Trackers
• Electrophysiology Study
• More

Atrial fibrillation, or AFib, may or may not cause symptoms. Your doctor could find it during a regular physical. Or you might make an appointment after you notice signs like a fluttering heartbeat or fatigue.

If your doctor thinks you have it, the first thing they’ll do is listen to your heart. They may be able to hear your irregular heartbeat with a stethoscope. If not, they may ask for tests to confirm the diagnosis, find out what’s causing it, and figure out the best way to treat it.

Sometimes your primary care or family doctor is the one who diagnoses AFib. But your doctor may refer you to a:

• Cardiologist, a doctor who specializes in heart diseases and conditions
• Electrophysiologist, a doctor who specializes in arrhythmias

When you make an appointment with your doctor or the specialist to see if you might have atrial fibrillation, ask if you need to do anything to prepare. You may need to follow a special diet before blood tests, for example.

To make the most of your time with the doctor, be ready to describe your symptoms and when they happen. Make a list of medications you take, including supplements and over-the-counter medicines. And be prepared with information about your health history and that of close family members.

Take note of any questions you have for your doctor, such as:

• What could be causing my symptoms?
• What kind of tests will I need?
• What are the recommended treatments for my condition? Are there any effective alternatives?
• Do I need to make changes to my lifestyle?

During your exam, the doctor will ask detailed questions about your:

• Symptoms
• Health habits
• Health problems
• Family medical history

During the physical exam, they are likely to:

• Listen to your heartbeat’s rate and rhythm
• Take your pulse and blood pressure
• Listen to your lungs

Yes. This simple, painless test is the most helpful to diagnose AFib. It records your heart’s electrical activity. It can show the:

• Speed of your heartbeat
• Rhythm of your heartbeat
• Strength and timing of electrical signals passing through your heart

A doctor or technician places small patches, called electrodes, on different areas of your body, including several on your chest. These pick-up signals that make wave patterns on the EKG results. It gives your doctor a picture of your heart’s overall electrical activity.

But because the test is a quick snapshot, a standard EKG won’t always catch AFib. Sometimes you’ll need a portable heart rhythm monitor to keep tabs on your ticker over a longer time.

You keep this device with you for 24 to 48 hours while it continuously records your heart’s electrical activity. The extra time gives a better chance of picking up an abnormal heart rhythm, what doctors call an arrhythmia.

Just as with a regular EKG, you’ll have small electrodes attached to your chest. Wires connect these electrodes to a small recorder you can clip onto a belt, keep in a pocket, or hang around your neck.

Then you just go about doing what you usually do. Your doctor will check the recorded results later.

This works like a Holter monitor, but it records your heart’s activity only at certain times, usually for a 30-day period. It might automatically start recording when it senses something is off. Or you might have to push a button when you feel:

• Dizzy
• Weak
• Lightheaded
• A racing or fluttering heart

You may need to wear it for a month or so — as long as it takes to catch and record the trouble.

You might hear this called mobile cardiac monitoring. You wear this small device 24/7, and it monitors your heart as you go about your daily life. Most send a Bluetooth signal to a data center, which analyzes the info and gives your doctor a report.

It’s just what it sounds like: A test that puts extra stress on your heart to see how it responds to working hard and beating fast. You’ll be hooked up to an EKG during the test, and the technician will watch your heart rate and blood pressure, too.

Exercise is an easy way to get your heart pumping. You might ride a stationary bicycle, or walk or run on a treadmill. That’s why this is sometimes called a treadmill test.

If your body can’t handle intense activity, you can take a special medicine that makes your heart beat faster instead.

This test uses sound waves and a computer to create a moving picture of your heart. An echo gives your doctor information about:

• The size and shape of your heart
• How well the heart muscle and valves are working
• Where the heart muscle isn’t contracting the right way

Transthoracic echocardiogram (TTE). This imaging test gives your doctor a picture of your heart. The doctor uses a device called an ultrasound transducer to give off and read sound waves that bounce off the walls and valves in your heart. A computer uses the data to create a video of your heart. Your doctor can see the size of your heart, how well it’s working, how well your heart valves are working, and if you have any blood clots.

Transesophageal echocardiogram (TEE). This imaging test gives the doctor a picture of your heart. They’ll place a probe down your esophagus (the tube that connects your mouth to your stomach). It goes right behind your heart. Once the probe is in place, it works the same way as a TTE.

These can point your doctor to what might be causing your AFib. Blood tests may check for infection, thyroid and kidney problems, signs of a heart attack, and more.

You might hear this called a handheld EKG. Or it could look like a wristwatch. It has electrodes on the back that take your pulse at your chest or your wrist. You can get one from a discount store, drugstore, or online. The doctor may suggest you do it so you can take a quick reading when you feel something. It’ll store your EKG data in its memory for your doctor to read.

Popular smartwatches outfitted with special sensors called photoplethysmographic sensors (or PPGs) can detect AFib.

An electrophysiology study (EPS) can help your doctor understand what’s causing your abnormal heartbeat and figure out the best way to treat it.

In this operation, your cardiologist inserts a thin, flexible electrode into a blood vessel leading to your heart, usually in your neck or groin. They then use an imaging system to guide the electrode to your heart. Once there, the electrode can measure your heart’s electrical signals.

Your doctor will give you a numbing medication before the surgery to keep you from feeling pain. You might also get a sedative to help relax you. The procedure may take 1-4 hours, and you’ll rest in a recovery room for 4-6 hours after that.

Top Picks

Diagnostics and treatment of atrial fibrillation (atrial fibrillation) in Krasnoyarsk

Atrial fibrillation (AF), or atrial fibrillation (many doctors still call it that), is one of the most common arrhythmias.

It is more common in older people than in younger people. Let’s figure out together why it occurs – the causes of atrial fibrillation – and how it can be dangerous for a person.

In the human heart there are not only muscle cells (myocardium), which contract and ensure the work of the heart as a pump for pumping blood, but also special cells that generate electric current and conduct it to the myocardium. The so-called conduction system of the heart consists of these special cells, through which an electrical impulse propagates. In a healthy heart, an electrical impulse that stimulates the contraction of the heart occurs in the right atrium, in the sinus node. Therefore, a normal heart rhythm is called sinus. From the sinus node, the impulse propagates along the fibers of the conducting system in the atria, causing them to contract. Blood is pumped through the open mitral and tricuspid valves into the ventricles of the heart. Then the impulse enters the atrioventricular node (atrioventricular), which is a kind of checkpoint into the ventricles. Fibers come out of it, called the “legs of the bundle of His”. Moving along the bundle of His, the impulse leads to a contraction of the ventricles and the release of blood into the aorta and pulmonary artery.

In a healthy heart, the impulse is formed at regular intervals, from 60 to 90 times per minute. In different situations, the pulse rate of the same person is 60 (for example, in a state of rest and rest), and 90 (during physical exertion, excitement) beats per minute. By changing the pulse rate, a healthy heart adjusts to the body’s changing oxygen needs. The same happens with blood pressure, which can vary throughout the day from 100/70 to 140/90 mmHg Art. (fine).

What is atrial fibrillation?

When atrial fibrillation (atrial fibrillation) the electrical impulse moves through the atria chaotically, instead of “friendly” contraction of the atria, they tremble, “flicker”. Due to the fact that the muscle fibers of the atria contract at different times, there is no single contraction and ejection of blood into the ventricles. Since the atria begin to contract not only chaotically, but also very often, the atrioventricular node does not pass all the contractions to the ventricles, an equal period of time is not observed. Therefore, when you try to count the pulse, the intervals between beats will be different, and the pulse will be “uneven”. Also note that the pulse has become different in content – one contraction is stronger, and the other can barely be determined under the fingers. The reason for this phenomenon is the disorganized work of the heart. Part of the contractions of the ventricles occurs when they have had time to fill with blood, and part – with empty ventricles, “idling.”

Forms

Atrial fibrillation (atrial fibrillation) may be paroxysmal or chronic. If attacks of arrhythmia (paroxysms) do not last long (from a few minutes to 7 days) and the normal rhythm is restored spontaneously, this form of atrial fibrillation is called paroxysmal.

Can atrial fibrillation be a health hazard?

Atrial fibrillation (atrial fibrillation) in most cases does not directly threaten your life, as it happens with ventricular tachycardia, ventricular fibrillation. To a greater extent, atrial fibrillation affects the accelerated development of heart failure, reducing the quality of human life. However, in certain situations, patients with atrial fibrillation are at risk. The chaotic contraction of the muscle fibers of the atria leads to the fact that instead of a complete simultaneous emptying of blood from the atria into the ventricles, the blood begins to stagnate in the atria. Conditions arise for the formation of blood clots (thrombi), which sometimes move with the blood flow into the ventricles and further into the systemic circulation. Such traveling clots (emboli) can clog the vessels of the brain (causing a stroke), limbs, and internal organs. Complication can be fatal.

The most favorable conditions for the formation of blood clots are created in chronic (permanent) form of atrial fibrillation , or if paroxysm atrial fibrillation lasts more than 2 days. In addition, AF (atrial fibrillation) contributes to the onset and progression of heart failure and coronary insufficiency. In patients with cardiac arrhythmia, the quality of life is significantly reduced: a constant feeling of danger of arrhythmia at any time, complete dependence on the availability of medical care.

Symptoms of atrial fibrillation (atrial fibrillation)

Atrial fibrillation, or atrial fibrillation , manifests itself in different ways: ic). With paroxysmal form of fibrillation , attacks of different duration occur, from several minutes to 7 days. Such attacks stop spontaneously. With a stable form of atrial fibrillation , paroxysms do not go away on their own, last more than 7 days, the help of doctors is needed to restore sinus rhythm (medication or electrical impulse therapy). At permanent form of atrial fibrillation fails to restore sinus rhythm.

Most often, atrial fibrillation begins with a paroxysmal form, later the attacks become more frequent, longer, it is more and more difficult to restore sinus rhythm, and then it is not possible at all – atrial fibrillation passes into a permanent form . For any form of atrial fibrillation, drug treatment is required, which should be carried out under the supervision of a physician. Atrial fibrillation can be detected during a screening mass ECG study, for example, when recording a stationary ECG during a physical examination or accidentally, when recording an ECG over the phone at a sports center, pharmacy or laboratory. Sometimes paroxysm of atrial fibrillation may develop during exercise tests, such as bicycle ergometry (VEM). But most often paroxysms of atrial fibrillation (atrial fibrillation) can be registered during long hours of ECG recording on a special small portable monitor – Holter monitoring .

Causes of atrial fibrillation (atrial fibrillation)

Causes that lead to atrial fibrillation (atrial fibrillation) may be different. Atrial fibrillation can be an independent disease (idiopathic form), but more often atrial fibrillation occurs in people suffering from cardiovascular diseases: valvular heart disease, coronary heart disease, hypertension, cardiomyopathy, pericarditis and myocarditis, heart surgery. Also at risk of getting atrial fibrillation are people suffering from thyroid pathology (hyperthyroidism – thyrotoxicosis, or “toxic goiter”). Sometimes rhythm disturbance is the first manifestation of thyroid disease, so at the first paroxysm of atrial fibrillation doctors always examine her.

The following video (in English) describes atrial fibrillation in great detail and clearly:

Alcohol abuse is also a common cause of atrial fibrillation . Frequent alcohol intake disrupts the level and balance of electrolytes in the blood (potassium, sodium and magnesium ions are very important for the work of any muscles, but primarily for the heart) and has a direct toxic effect on the heart, leading to the expansion of the atria and ventricles, reducing contractile function. Perhaps the appearance of atrial fibrillation in patients with chronic lung diseases, against the background of general severe diseases, pathology of the gastrointestinal tract (reflux esophagitis, hiatal hernia) is also one of the causes of atrial fibrillation, or atrial fibrillation.

Atrial fibrillation: what to do, how to treat?

Diagnosis of atrial fibrillation (atrial fibrillation) is based on an electrocardiogram (ECG) recording. Sometimes atrial fibrillation is asymptomatic and is detected by chance, for example, when an ECG is recorded with prof. examination or during inpatient treatment for another disease. However, most often the patient goes to the doctor with complaints of interruptions in the work of the heart, attacks of rapid, irregular heartbeat, which may be accompanied by weakness, shortness of breath, sweating, dizziness, a feeling of “internal trembling”, pain in the heart area and a decrease in blood pressure. When an attack occurs suddenly, you should definitely consult a doctor or call an ambulance team. It is very important that the ECG recording be made exactly at the time of the attack – the doctor will be able to accurately determine the nature of the arrhythmia, make a diagnosis and prescribe the correct treatment.

If attacks occur frequently enough, but they cannot be “caught” on a conventional ECG, the patient is referred for 24-hour ECG monitoring (Holter, Holter monitoring). Within 24 hours (or more, depending on the device), the patient’s ECG is recorded and recorded electronically with a special palm-sized device that the patient carries with him. The record is processed on a computer, and if during the examination the patient had attacks of arrhythmia, they will be recorded and documented. The doctor will receive all the necessary information.

It may happen that no seizure occurs during Holter monitoring. A second study will be required, and so on until the arrhythmia is “caught”. If seizures are rare, this is very difficult to do. In such cases, the doctor may recommend a test to provoke the onset of an attack – transesophageal atrial stimulation (TEAS). When performing PPSP, a thin electrode is inserted through the patient’s nose into the esophagus, which is installed at the level of the atria and, using a special device, allows electrical impulses to be applied to the heart. If a paroxysm of AF occurs, an ECG is recorded, then sinus rhythm is restored. CHPSP is carried out only in a hospital, in special departments specializing in the treatment of cardiac arrhythmias.

Atrial fibrillation paroxysm – what to do?

If you experienced an attack of uneven heart palpitations for the first time, you should immediately consult a doctor or call an ambulance team. Even if you feel good. Remember – it is very important to fix the attack on the ECG. The attack may end on its own after a while, but it is necessary to restore the correct rhythm within the first two days. The more time passes from the onset of the paroxysm, the more difficult it is for the heart to restore normal functioning and the higher the risk of blood clots in the chambers of the heart. If more than two days have passed since the onset of the attack or you do not know exactly the time of its occurrence, it is necessary to restore the heart rhythm only under the supervision of a doctor after examining the heart chambers on echocardiography, echocardiography (to exclude already formed blood clots) and special preparation with blood thinners (to prevent thrombosis).

If paroxysms of atrial fibrillation (atrial fibrillation) occur frequently, it is necessary to develop a plan of action with your doctor during an attack. With good tolerability of arrhythmia and with short (no more than 24 hours) attacks of arrhythmia, which often end on their own, you can not take special actions. It is necessary to continue taking the drugs recommended by the doctor without changing the dose. Your doctor may recommend a single dose of an antiarrhythmic drug in addition to basic therapy, or a temporary increase in the dose of medications already taken, when an attack occurs. If during the paroxysm of atrial fibrillation the state of health worsens significantly, or the arrhythmia lasts more than a day, a visit to the doctor is mandatory.

Which is “better” – seizures or persistent atrial fibrillation (atrial fibrillation)?

For a long time, doctors believed that the only optimal result of treatment was the restoration of proper, sinus rhythm. And now, in most cases, the doctor will advise you by all means to restore and maintain sinus rhythm. However, not in all cases. Studies have shown that if it is impossible to effectively maintain the restored sinus rhythm (when the heart constantly “breaks” into atrial fibrillation), permanent atrial fibrillation (atrial fibrillation) with medically controlled heart rate of about 60 beats per minute is safer than frequent paroxysms of atrial fibrillation (especially protracted, requiring the introduction of high doses of antiarrhythmic drugs or electrical impulse therapy).

The physician decides whether to restore sinus rhythm or maintain permanent atrial fibrillation. In each case, such a decision is individual and depends on the cause of the development of arrhythmia, the disease against which it arose, on its tolerance and the effectiveness of the treatment of atrial fibrillation to maintain the correct rhythm.

An attack that lasts more than two days should be treated only under medical supervision, after special training. If sinus rhythm is successfully restored, your doctor will adjust your ongoing antiarrhythmic therapy and recommend taking blood thinners for at least a month after cardioversion.

Treatment of atrial fibrillation (atrial fibrillation)

There are several ways to treat atrial fibrillation (atrial fibrillation) – restore sinus rhythm. This is the intake of antiarrhythmic drugs inside, the introduction of antiarrhythmic drugs intravenously and cardioversion (electropulse therapy, EIT). If the doctor restores the rhythm in the clinic or at the patient’s home, most often they start with intravenous drugs, then taking pills. The procedure is carried out under ECG control, the doctor observes the patient for 1-2 hours. If the restoration of sinus rhythm has not occurred, the patient is hospitalized in a hospital. In the hospital, drugs can also be administered intravenously, but if the time is limited (the duration of the attack approaches the end of the second day) or the patient does not tolerate the paroxysm (a decrease in blood pressure is observed, etc. ), EIT is more often used.

Cardioversion is performed under intravenous anesthesia, so the electrical shock is painless for the patient. The success of rhythm recovery depends on many factors: the duration of the attack, the size of the heart cavities (in particular, the left atrium), sufficient saturation of the body with an antiarrhythmic drug), etc. EIT efficiency approaches 90-95%.

If the paroxysm of atrial fibrillation lasts more than two days, it is possible to restore the rhythm only after special training. The main stages are taking blood-thinning drugs under the control of a special analysis (INR) and transesophageal echocardiography (TEE) before EIT to exclude blood clots in the heart cavities.

Attacks of atrial fibrillation – how to prevent?

In order for the paroxysms of atrial fibrillation not to resume, the patient must constantly take an antiarrhythmic drug. For the purpose of prevention. To date, there are many antiarrhythmics, the choice of the drug should be made by the doctor. A patient with atrial fibrillation needs to be monitored by a cardiologist, during which regular examinations are carried out (for example, echocardiography once a year, or daily Holter monitoring, if necessary, to assess the effectiveness of treatment), treatment correction. The selection of drug therapy is always, for any disease, a very painstaking task that requires literacy and perseverance on the part of the doctor and understanding and diligence on the part of the patient. Individual can be not only the effectiveness, but also the tolerability of treatment.

Failure of medical therapy for atrial fibrillation may be an indication for surgical treatment. In the left atrium (near the confluence of the pulmonary veins) there are zones in which electrical impulses are formed that can trigger atrial fibrillation. The increased electrical activity of these zones can be detected using a special electrophysiological examination (EPS). A special catheter is inserted into the cavity of the heart, the information obtained allows you to make an electrical “map” and determine the trigger (“starting”) areas. The study is performed under local anesthesia and is quite safe for the patient. After determining the “starting” areas, an operation is performed – radiofrequency ablation of trigger zones (RFA). The catheter, using high-frequency current, destroys these areas and disrupts the triggering of the arrhythmia. In four cases out of five, atrial fibrillation no longer resumes. In an animated form, the RFA process of trigger zones in atrial fibrillation is presented in the video.

Atrial fibrillation became permanent

In a certain proportion of patients suffering from attacks of atrial fibrillation, sooner or later there comes a time when it is no longer possible to restore sinus rhythm. Atrial fibrillation becomes permanent. As a rule, this happens in patients with significantly enlarged left atrium (4. 5 cm or more). Such an enlarged atrium is simply not able to maintain sinus rhythm. With a permanent form, the patient also needs medical supervision.

The goals of treatment are to keep the heart rate within 60-70 beats per minute at rest, prevent the formation of blood clots in the heart cavities and reduce the risk of thromboembolic complications.

Heart rate control is carried out with beta-blockers, digoxin or calcium antagonists (verapamil group), selecting an individual dose of the drug according to the principle “the higher the dose, the lower the heart rate.” At the optimal dose, the titration is completed and the patient receives it daily. The effectiveness of heart rate control can be assessed using 24-hour Holter ECG monitoring. If a decrease in the frequency of the rhythm cannot be achieved with pills, doctors resort to surgical methods. The arrhythmologist surgeon isolates the atria from the ventricles and implants a pacemaker that is programmed for a certain number of heartbeats at rest and adapts to stress.

To prevent thrombus formation, drugs are used that “thinn” the blood, that is, slow down the processes of blood clotting. For this purpose, aspirin and anticoagulants (most often warfarin) are used. To date, the approach to the tactics of anticoagulant therapy is determined on the basis of an assessment of the risk of thromboembolic complications and the risk of bleeding while taking these drugs, and is approved in the National Russian recommendations of the All-Russian State Audit Committee.

Many patients are afraid to start taking medications because complications such as bleeding are listed in the instructions. You should know that before prescribing anticoagulants, the doctor always weighs the benefits and risks of treatment with the drug, and prescribes only when he is completely sure that the benefits greatly outweigh the risks. Strict adherence to the recommendations and regular monitoring of blood tests (international normalized ratio (INR) for patients receiving warfarin) plus your awareness of the main mechanisms of action of the drug and the tactics of your actions at the first signs of bleeding make such treatment completely predictable and as safe as possible.

Relatively recently, endovascular occlusion of the left atrial appendage began to be performed in Russia to prevent the development of stroke in patients with chronic atrial fibrillation. The operation is an alternative to the use of anticoagulants in patients for whom these drugs are contraindicated, or for those who are indicated for the use of warfarin, but for one reason or another they do not receive it. Over 90% of thrombi that cause cardioembolic strokes in non-valvular atrial fibrillation form in the “ear” (natural appendage) of the left atrium, due to a decrease in blood flow velocity. This operation is performed in an X-ray operating room under dual control – transesophageal echocardiography and fluoroscopy.

Preliminary analysis of computed tomography data. For access, a puncture and catheterization of the femoral vein is performed. Through the conductor, the instruments are passed into the right atrium, after positioning, the interatrial septum is punctured, and through this puncture the conductor enters the left atrium. Then the implantation site is selected and the size of the occluder is selected. The occluder is installed at the mouth of the left atrial appendage, stopping the blood flow in it and, thus, the appearance of blood clots in this anatomical formation is excluded. In Krasnoyarsk, such operations are performed at the Regional Clinical Hospital.

Cardiologists of the “Center of Modern Cardiology” have not only all modern functional and laboratory methods for diagnosing diseases that cause atrial fibrillation , but also vast experience in diagnosing and treating various forms of atrial fibrillation .

About atrial fibrillation – read also AFIB Matters (in Russian)

Automatic blood pressure monitor BP B3 AFIB Microlife

Microlife BP B3 AFIB is an automatic blood pressure monitor with AFIB technology, which allows you to determine atrial fibrillation (the main cause of strokes) in the process of measuring pressure. This device also implements MAM technology: the tonometer automatically takes three consecutive pressure measurements at 15-second intervals, analyzes the results and calculates a clinically accurate average value.

Key benefits:

• AFIB – atrial fibrillation detection technology during pressure measurement (on three MAM measurements). If the AFIB icon is displayed on the displays of the device during the measurement of blood pressure, immediately consult a doctor for an ECG.

• MAM – Analysis of three consecutive blood pressure measurements in less than 3 minutes for maximum reliability with automatically weighted data.

• PAD technology (IHB) – accurate determination of pressure indicators in the presence of any violations of the pulse rhythm. If an irregular heart rate occurs during measurement, the PAD icon (IHB) is displayed. The technology helps to detect pulse disorders at an early stage (it is necessary to contact a cardiologist).

• Gentle+ Technology – Inflates the cuff to the level required for measurement, making the process more comfortable.

• Memory for 99 measurements per user.

• Tapered cuff M-L size.

• An indicator of arm movement and a correctly worn cuff will help you get an accurate result.

• Cuff inflation level indicator.

• Case included.

Specifications:

Dimensions	138 x 94.5 x 62.5 mm
Weight	402g (including batteries)
Atrial fibrillation diagnostic function	Yes (Afib-technology) on 3 dimensions MAM
Memory	99 measurements
Warranty	11 years
Power adapter	No
Accuracy class	Higher (A/A)
Pouch	Yes
Multi measurement mode	Yes (MAM technology)
Display	4-line
Display
Type	automatic
Cuff	shoulder 22-42 cm
Color chart	Yes
Movement indicator	Yes
Wrong cuff indicator	Yes
Average pressure calculation	Yes
Number of users	1 user
Battery indicator	Yes
Cuff inflation indicator	Yes
Clock	Yes
Features
Power supply	4 x 1. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website