Atrial Fibrillation

Atrial fibrillation, or AFib, is an irregular heartbeat that can cause blood clots, stroke, heart failure and other heart-related conditions. Around 2.7 million people in the United States have AFib, and it is expected to double in the next 2 decades. The University of Kansas Health System offers comprehensive heart care for people with atrial fibrillation.

Atrial fibrillation is the most common type of heart rhythm disorder. It occurs when there are abnormalities or damage to the heart’s structure. It can be caused by several other heart conditions, such as high blood pressure, diabetes and sleep apnea.

During AFib, the upper chambers of the heart do not pump blood effectively into the lower chambers. It causes the heart to beat irregularly and, oftentimes, too fast. It can also cause blood to become stagnant in parts of the upper chambers. This can cause a blood clot, which may eventually lead to a stroke. The risk of developing a stroke is why people with atrial fibrillation are often prescribed blood thinners. Many people are unaware that AFib is a serious condition that may require emergency medical treatment.

Atrial fibrillation usually occurs in brief episodes, but it can also be persistent or permanent. Types of atrial fibrillation include:

Your doctor will determine if your symptoms are related to atrial fibrillation or another heart-related disorder and recommend a treatment plan.

Abnormalities or damage to the heart’s structure can cause atrial fibrillation. People with atrial fibrillation may experience symptoms such as:

• Chest pain
• Dizziness
• Fatigue
• Heart palpitations
• Lightheadedness
• Reduced ability to exercise
• Shortness of breath
• Weakness

Patients with the following conditions have an increased risk of developing atrial fibrillation:

• Age
• Chronic kidney disease
• Diabetes
• Enlargement of the chambers on the left side of the heart
• Heart failure
• High blood pressure
• Hyperthyroidism
• Ischemic heart disease, which occurs when the heart does not get enough blood or oxygen
• Moderate to heavy alcohol use
• Obesity
• Smoking

You can reduce your risk of atrial fibrillation by:

• Eating a heart-healthy diet
• Increasing your physical activity
• Limiting alcohol and caffeine
• Limiting your use of cough and cold medications, which contain stimulants that can increase your heart rate
• Maintaining a healthy weight
• Not smoking

In order to diagnose atrial fibrillation, your physician will review your symptoms and medical history. They may also use cardiac diagnostic tests, such as:

• Echocardiogram: An echocardiogram is a test used to create moving pictures of your heart. A transducer, or wand-like device, is held on your chest. Sometimes, a flexible tube with the transducer is guided down your throat through to your esophagus. This test allows your doctor to diagnose structural heart disease or blood clots in the heart.
• Electrocardiogram (ECG): An ECG is the primary tool for diagnosing atrial fibrillation. It involves using small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart.
• Event recorder: This portable ECG device monitors your heart activity over a few weeks or months. When you experience an increase in your heart rate, you push a button, and it records your heart rhythm for several minutes. This allows your doctor to determine your heart rhythm at the time of your symptoms.
• Holter monitor: This portable ECG device records your heart's activity for 24 hours or longer, which allows your doctor to look at your heart rhythms.

Other diagnostic tests may include:

• Blood tests
• Chest X-ray
• CT scan of the heart
• Exercise test
• Sleep study (if necessary)
• Stress test

Once you have been diagnosed with atrial fibrillation, your doctor will determine a treatment plan. It may include:

• Treatment to prevent you from having a stroke, which may include blood thinners and occasionally an implanted Watchman device
• Treatment to prevent your heart rate from going too fast, which typically include medications and occasionally an implanted pacemaker
• Treatments to keep your heart rhythm normal, which may include:
• Advanced procedures to keep your heart in a normal rhythm
• Antiarrhythmic medications, which help your heart return to its natural rhythm
• Electrical cardioversion, which uses external patches to shock your heart and reset your heart’s natural rhythm

In many patients, rhythm medications may not be effective or tolerated. Your doctor may recommend advanced procedures, such as:

• Catheter ablation, which involves using a catheter to destroy areas of heart tissue that cause irregular heartbeats
• Maze procedure, which involves creating a pattern of scar tissue that disrupts stray electrical impulses that cause atrial fibrillation

• The University of Kansas Health System offers comprehensive care for people with atrial fibrillation. We are home to the region’s first and largest center of excellence in atrial fibrillation, which includes a dedicated atrial fibrillation program.
• Our heart rhythm specialists, also called electrophysiologists, are internationally recognized as leaders in their field. They have additional training in electrophysiology and are board-certified in cardiac electrophysiology. They are fellows of the American College of Cardiology, the American Heart Association and the Heart Rhythm Society. They perform leading-edge research and provide the latest treatments to patients with heart rhythm disorders. Our electrophysiologists also work closely with our heart surgeons and heart failure specialists to treat patients who may require heart surgery or whose heart rhythm disorder is related to heart failure.
• Our multidisciplinary team includes specialists from preventative cardiology, weight management, pharmacy, sleep apnea and heart failure management. We offer AFib nurse navigators to help coordinate clinic visits. Our A-Fib advanced practice providers and cardiac electrophysiologists collaborate to provide an individualized treatment plan.