Cardiologist Q&A: When your heart skips a beat

Odds are either you or someone you know has suffered from an arrhythmia—a fast or irregular heartbeat. Otherwise known as atrial fibrillation, Afib is one of the more common heart conditions in the U.S. According to the Centers for Disease Control and Prevention, it affects 2.2 million people per year. When Afib strikes, it interrupts the normal flow of blood and can put you at risk of blood clots and stroke. While it’s concerning, the good news is it’s treatable. 

We spoke with Providence St. Joseph Hospital Heart & Vascular cardiologist Danny Y. Lee, MD, and cardiologist/ electrophysiologist Thuy Le, MD, to find out what you should know about this condition. 

What causes Afib?

Dr. Danny Lee: Overall, atrial fibrillation can be triggered by any process that places stress on the heart. Many factors can affect this, including age, hypertension, obesity, alcohol abuse, thyroid disease, obstructive sleep apnea, heart failure or heart attack, chronic obstructive pulmonary disease, acute illness or recovery from a procedure or surgery.

What are the symptoms of Afib?

Dr. Thuy Le: The most common symptoms are palpitations, shortness of breath, chest pain, dizziness, syncope (fainting or sudden temporary loss of consciousness), fatigue and weakness. Sometimes, however, there are no symptoms at all. 

How is Afib treated?

Dr. Lee: There are three components of Afib management: stroke prevention, heart rate control and rhythm control. 

Strokes can be prevented by taking a blood thinner to prevent clot formation within the heart. Another safe, one-time, long-term alternative is a device called Watchman. It prevents blood clots from forming and causing a stroke. The highly successful Watchman program at Providence St. Joseph Hospital has the highest volume of patients in Orange County. 
Heart rate control is generally achieved with medications that slow electrical conduction, such as beta blocker or calcium channel blocker medications. 

Rhythm control can be achieved either with anti-arrhythmic medications or a catheter ablation procedure to cauterize or to freeze the atrial tissue, which electrically isolates the triggers for Afib. 

What are possible consequences of having Afib? 

Dr. Le: If left untreated, Afib can lead to stroke, heart failure and dementia. Because the heart does not effectively pump when it’s in Afib, this can cause blood clots, which in turn can cause a stroke. Afib can also weaken heart muscles, leading to congestive heart failure. When Afib is associated with slow heart rates, the insertion of a pacemaker may be required.

Are there ways to prevent Afib or reduce one’s risk?

Dr. Lee: The risk for Afib can be reduced by staying active, exercising, losing excess weight and avoiding excessive alcohol and caffeine consumption. It is also important to effectively manage the other health conditions that can contribute, such as controlling blood pressure, using CPAP for sleep apnea and treating thyroid disease. 

To learn more about our Heart & Vascular program or make an appointment with one of our expert cardiologists, call 844-925-0945.

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