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Atrial Fibrillation – What Exactly is It?
Atrial Fibrillation (AF) or Afib as I like to call it, is the most common heart rhythm disorder and affects about 1% of the population. It becomes even more common with increasing age. It rarely occurs in those under 40, but occurs in up to 5% percent of those over 80. Its favorite age to strike is “my age” late forties to early fifties. I am 52; mine started when I was 51 but could go on for months or even years without being noticed. It should be said that Atrial Fibrillation is an electrical problem in the heart and not a lead problem like a normal heart attack or blockage.
Normal Heart Electrical Activity and What Goes Wrong in Atrial Fibrillation.
The heart is basically a large muscular pump that drives blood around the body. To do this correctly, the chambers of the heart, there are four of them, must be precisely controlled electrically, so that they work together as one pumping unit. The normal heartbeat begins with the sinoatrial or Sinus Node natural pacemaker located in the upper right heart chamber (the right atrium). That electrical pulse spreads across both upper chambers, the atria, causing them to contract. The contraction of the atria moves blood into the two ventricles, which are the main pumping chambers. The electrical signal is delayed by about a tenth of a second by a special structure called the atrioventricular (AV) node, and then spreads rapidly through the ventricles to cause them to contract. This extra filling of the ventricles of the atrium is not essential, but serves to “press the ventricular pump” and improve general heart function.
Those atria that contain the natural pacemaker, the SA node, are the part of the heart involved in Atrial Fibrillation. The ventricles, the muscular part of the heart that actually pumps the blood, are electrically isolated from the atria, and the only way the electrical signal can reach them is through the AV node.
A normal heart rhythm is called sinus rhythm (no, nothing to do with your nose)
Most people have a resting heart rate of between 60 and 80 beats per minute. In Atrial Fibrillation, the atria contract rapidly and irregularly at rates of 400 to 600 beats per minute. As luck (see GOD) would have it, the AV node will not allow as many signals through the ventricles; only about 1 or 2 out of every 3 Atrial beats pass to the ventricles. Even so, the ventricles beat too fast, at rates of 110 to 180 beats per minute. (Mine was over 170!)
The Most Common Symptoms:
Feeling out of breath, reasonable because your heart beats faster than if you ran a marathon.
Heart palpitations (sudden pounding, fluttering or racing feeling in the chest).
Lack of energy; feeling too tired.
Dizziness (feeling weak or light-headed).
Chest discomfort (pain, pressure or discomfort in the chest area)
In my case – inability to sleep lying down
Slow it down!
The first thing you want to do is check the runaway heart rate. This is done with drugs and even cardioversion. (similar to the crash paddles and electric shock as seen on TV) The goal is to get the heart to beat in a uniform, normal way again. This is called Normal Sinus Rhythm and is the Holy Grail that all of us Afibers want to achieve.
I just touched on the simple mechanics of a complicated problem. Please read the other articles as we go into more detail and try to explain the true “nature of the beast” – Atrial Fibrillation.
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