Facts You Need To Know About Atrial Fibrillation

Featuring Dr. Milan Gupta, MD, FRCPC, Cardiologist Video Title: The Facts You Need To Know About Atrial Fibrillation - Cardiologist Duration: 3 minutes, 54 seconds Atrial fibrillation or AF is a rhythm disturbance. It's a problem in how the heart beats.

And typically in AF, the heart starts beating irregularly and often rapidly. This is the most common rhythm disturbance out there. It is age related, so its likelihood increases as we get older, although it can still occur in children and young adults.

AF can actually occur intermittently; it can come and go, or it can stick and a patient can then be an AF permanently. When AF occurs at a younger age, it's more often intermittent. And as we age, it becomes permanent.

AF can be silent; people may not know they're in AF or going in and out of it. But it can also cause symptoms. It can cause palpitations or a sense of the heart fluttering; it can cause shortness of breath, chest pain, dizziness and fatigue.

AF is a very important rhythm disturbance for a number of reasons. The first is it is often associated with other risk factors or actual heart disease. And the most powerful risk factor for AF is high blood pressure, or hypertension, which is also extremely common in our society and which also can be completely silent.

So if a patient is diagnosed with AF one of the first things to look for is whether or not that patient has high blood pressure, or underlying heart disease.

Now AF is important for other reasons. In the short term, it can make a patient feel unwell: shortness of breath, palpitations, lack of energy, and therefore, treatment goals are to make the patient feel better.

But in the long run, even if we can get the patient to feel better, AF is associated with a substantially increased risk of stroke. And that’s because when the heart beats irregularly, as it does in AF, blood clots can form inside the heart. Small clots that we can’t see, for example, on an ultrasound, but if those clots develop, then pieces can break off and travel to the brain, resulting in serious stroke.

While the vast majority of people with AF will require some sort of treatment to reduce their stroke risk, not every single patient needs treatment.

In order to determine who needs treatment, one has to look at risk factors for stroke other than the AF. And that includes things like age, whether or not the patient has high blood pressure or diabetes, whether the patient has had other heart problems or whether the patient has had actually a previous stroke.

When we put all of that information together, we can get a risk score. The higher the risk, the higher the need for treatment.

Once you’ve been identified as needing treatment to prevent stroke for AF, the gold standard for decades has been a drug called warfarin, or Coumadin, which is a blood thinner, and it’s very effective, but it has its limitations.

Thankfully, there are now several new options available for the management of stroke and AF, and these new drugs offer significant advantages over warfarin, both in terms of protection against stroke and in terms of safety against major bleeding. Some of these drugs are offered as once-a-day options, others as twice-a-day options.

If you have AF or if you’re concerned, talk to your doctor.

Presenter: Dr. Milan Gupta, Cardiologist, Brampton, ON

Local Practitioners: Cardiologist