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Understanding AFib for a novice

According to the American Health Association, there are 2.7 million Americans living with Atrial Fibrillation today.

I’m one of them.

Most people perceive Atrial Fibrillation, also known as AFib, as the heart going out of rhythm. While this is fundamentally true, a more accurate description would be the “upper chambers of the heart (the atria) [beating] irregularly (quiver) instead of beating effectively to move blood into the ventricles.” (animation)

Symptoms include palpitations, dizziness, fainting, fatigue, chest pain, and shortness of breath. During my initial AFib event (around spring in 2017), my primary symptom was shortness of breath (and usually during significant activity); a more relatable description might be that it felt like my body was fighting off a cold… and not going through abnormal electrical discharges that was causing the atria to quiver. Without knowing it at the time, my heart rate was sustained at 150 beats/minute. According to the book on universal logic, “that ain’t good, bro.” My doctor shipped me to the Emergency Room, who within an hour admitted me to a hospital where I was treated and released a day later.

The biggest risks of AFib are bloods clots and, if left untreated, strokes. Treatment starts with medication and Cardioversion, designed to restore normal rhythm and prevent risk factors for strokes. During my initial treatment in March, my cardiologist performed a Cardioversion, a procedure that sends electrical shocks through electrodes via the chest, and then prescribed Metoprolol/Lopressor (a beta-blocker designed to relax blood vessels, slowing the heart rate, improving blood flow, and lowering blood pressure). While Cardioversion is almost always successful, it’s designed to restore the rhythm, not to cure the (currently unknown) trigger that’s causing it; and there’s always a risk of recurrence.

My doctor discovered AFib again last week (week of Oct. 13) and, with the inclusion of a new blood thinner, another Cardioversion is scheduled to restore my heart’s rhythm.

The question, still unanswered, is what’s causing this: It could be alcohol (which I’ve already cut out), caffeine (which I’ve greatly reduced), and sleep apnea (which I have and in treatment for), as well as other conditions such as obesity, diabetes, infections (only now recovering from ear and dental infections), and heart disease.

There are advancing treatments for AFib, including catheter ablation:

With catheter ablation, a surgeon inserts a thin flexible catheter, or tube, with an electrode on the tip into a blood vessel in the neck or groin, and steers it through the blood vessels and into the heart. Radiofrequency (heat) or cryo (cold) ablation is applied via the tube to areas that are likely to contain the abnormal heart tissue that’s causing atrial fibrillation. Small, circular scars are formed in those areas, allowing sinus, or normal, rhythms to be restored.

In the meantime, my worst case scenario is that AFib will always be a lingering threat, though managed and addressed. Until I breakdown for that tasty cup of coffee, then all bets are off.

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