What is paroxysmal atrial fibrillation
Author Ольга Кияница
Atrial fibrillation (AF) is the most common form of arrhythmia. It is a condition where a person has heart rhythm problems. In severe cases, complications such as ventricular fibrillation may develop, since an abnormal rhythm can be transmitted from the atria to the ventricles.
Paroxysmal atrial fibrillation (FPI) is defined as a fast, unstable heart rate that starts suddenly and stops on its own for 7 days. The attack of paroxysmal atrial fibrillation often lasts less than 24 hours.
For the diagnosis of AF, electrocardiography is primarily used.Additionally, echocardiography, MRI, CT and other diagnostic methods can be performed. After the examination of the patient, treatment is necessarily prescribed, which makes it possible to avoid serious complications.
Video: AFib and common triggers
Description of paroxysmal atrial fibrillation
In the normal state, the heart contracts with a frequency of 60-90 beats / min (an indicator for an adult). Since pathology is most often registered among the adult part of the population, the normal values for this category are taken into consideration.
The American Heart Association (AHA) indicates that 2.7 million
Americans live with some form of AF. The likelihood of paroxysmal form of AF increases with age.
Although paroxysmal AF itself is not life threatening, it can have serious consequences. For this reason, it is very important to diagnose and treat the problem as early as possible.
Statistics on paroxysmal atrial fibrillation:
- After 60 years, AF is determined in 5% of the population.
- After 75 years, it is diagnosed in 14% of the population.
- Among the prevalence of various forms of arrhythmias, AF takes second place after extrasystole.
- In Europe, the number of people with AF leaves about 4.5 million, and in the United States more than 2 million people.
- In Germany alone, about 1 million people are sick with AF.
- Approximately 13.5 billion euros are spent on treating patients with AF located in EU countries.
- In 30% of patients there are no significant heart disease.
Mechanisms of development of the TFG:
- In the myocardium of the atria, ectopic foci are formed, generating impulses bypassing the sinus node, as a result of which the normal rhythm is lost.
- The work of the sinus node is impaired, as a result of which the rhythm becomes abnormal and often accelerated.
- With ERW syndrome, there are additional ways to conduct impulses, as a result of which the activity of the heart quickens.
- The work of the nervous system (central and vegetative parts) is impaired, which contributes to the breakdown of the work of various organs and body systems, including heart dysregulation.
In some women, a change in the hormonal background, especially in the postmenopausal period, often leads to cardiac disturbance.
Paroxysmal atrial fibrillation occurs when abnormal electrical pathways appear in the myocardium. As a result, the heart begins to contract irregularly or does not pump enough oxygen-containing blood throughout the body.
Paroxysmal AF can be caused by an abnormal lifestyle, especially when it comes to taking illegal drugs, smoking, alcohol, obesity, and excessive exercise. In some cases, the disease may be associated with pre-existing or associated diseases, such as:
- Previously suffered a heart attack or heart surgery.
- Heart diseases, especially those associated with scarring and changes in the structure of the myocardium.
- Sleep apnea (respiratory arrest).
- High blood pressure.
- Lung disease.
Conducting a wrong lifestyle can also lead to paroxysmal AF, for example:
- Smoking (even if passive).
- Use other stimulants such as caffeine and some medications.
- Overweight or obesity.
- Bad sleep.
- Long physical exertion.
- Excessive alcohol intake.
The occurrence of PFP on the background of alcohol intake is sometimes called the “syndrome of the cardiac feast” because pathology is often first detected after weekends or holidays, when many people consume large amounts of alcoholic beverages.
Exercises and workouts are generally considered beneficial to health. However, patients with PFI should consult their physician before starting a new workout or increasing the intensity of the exercises. In some cases, an increase in physical exertion can also lead to the PFB, which is associated with the stress on the heart.
Common symptoms of paroxysmal AF are:
- Palpitations and shortness of breath are the most common symptoms.
- Inconsistent Breath
- Tiredness or weakness
In some cases, the patient is worried about chest pain. This symptom may indicate the development of heart failure. In such cases, do not hesitate to call an ambulance.
If you have to experience any of the above symptoms, you need to contact your doctor as soon as possible. Even if the symptoms disappear, a physical examination of the patient should be carried out with subsequent monitoring of the heart.
Sometimes there is no sign of illness. In such cases, the doctor will be able to diagnose the problem using additional methods of diagnosis by type of ECG or echoCG.
Electrocardiography (ECG) is a simple and painless test that includes sensors attached to the skin on the arms, legs, and chest. Sensors detect electrical signals emanating from a contracting heart. The result of the study is transmitted to the monitor and then the doctor determines the existing problems in the cardiac activity. An ECG test usually takes only a few minutes.
Echocardiography (echocardiography) uses sound waves to create a digital image of the heart. Shows various structural changes of the heart, valve defects are especially well diagnosed.
Radiography of the chest (WG OGK) - performed to search for signs of cardiovascular diseases, in particular, the contours of the heart and its transverse size can change.
Blood tests used to look for signs of other diseases that can cause fibrillation
Stress test , with which doctors check the work of the heart before and after performing physical exercises (on a treadmill, on a bicycle).
Holter monitoring is performed using a portable device that measures and records the activity of the heart over a period of one to two days.
The event monitor is a portable ECG that measures heart activity over a period of several weeks or several months.
In most patients, paroxysmal AF develops without any complications, but sometimes the pathology leads to serious consequences. For example, if you had to experience changes in the rhythm of the heart, you should immediately seek medical help.
Severe paroxysmal AF can lead to heart failure or stroke. According to the AHA, people who have atrial fibrillation are five times more likely to suffer a stroke than the rest of the population. This is due to the fact that PFP affects the blood flow throughout the body, including the brain. The blood may stagnate in the upper chambers of the heart and thicken, leading to thrombus formation. If a blood clot from the heart enters the brain with the bloodstream, it can block the artery and cause a stroke.
Warning signs of the onset of PFI:
- pale face;
- numbness or weakness in the arms, face, or legs, especially on one side of the body;
- difficult speech or speech comprehension;
- eye problems on one or both sides;
- dizziness, loss of balance and incoordination, as well as problems with walking;
- sudden severe headache without any obvious reason
In extreme cases, atrial malfunction is transferred to the ventricles, which contributes to the development of ventricular fibrillation. This is a critical condition that can only be resolved by intensive care.
There are various strategies for the treatment of paroxysmal AF, which include:
- Drug control of heart rate . This is the most common treatment of PFI. His goal is to reduce the heart rate to 60-80 beats per minute at rest, as well as to regulate the electrical impulses distributed throughout the heart.
- Anticoagulant therapy . Doctors can prescribe anticoagulants to prevent blood clotting in the heart cavities, which, in turn, reduces the likelihood of stroke.
- Electrical cardioversion . This therapy is based on the use of a weak electric current to restore the heart to a natural rhythm. In general, treatment is aimed at achieving the same goal as controlling heart rhythm. It is more commonly used when paroxysmal AF is tested for more than 48 hours.
Doctors often use anticoagulants with electrical cardioversion, which reduces the risk of stroke during the rhythm recovery process.
Another procedure for treating AF, called catheter ablation , involves cauterizing a region of the heart that generates extraordinary impulses that violate the heart rhythm.
During this procedure, the doctor inserts thin wires, called catheters, into a vein around a person’s neck or groin. These wires are then sent to the heart, where the pathological area is determined, and then, by applying an electrical impulse, destroy the problem area.
A patient undergoing this type of treatment is usually injected with a local anesthetic in the area where the wires are inserted. During the procedure, the person usually stays awake, but some people may fall asleep. Most patients return home on the same day, although if necessary the patient stays for some time in a hospital.
Because of the increased risk of complications arising during surgery, doctors most often recommend the treatment of paroxysmal AF with medical drugs.
Stopping smoking and avoiding excessive drinking will help reduce the likelihood of a recurrent episode of paroxysmal AF. It is also recommended to eat healthy and balanced food and in the presence of extra pounds to do everything possible to lose weight.
Avoiding stress, to the extent possible, is also a good way to reduce the chances of developing AF. Prolonged or sudden stress can contribute to the development of an attack of AF, so limiting emotional stress and practical exercises for relieving stress, such as yoga, can help to improve overall well-being.
Life with paroxysmal AF
Most people with paroxysmal AF live a normal and fulfilling life, not excluding those who need treatment. Life with paroxysmal AF is associated with the control of risk factors and provoking causes of exposure.
The development of a long-term heart rhythm management plan with the help of a doctor helps especially well.
Normal daily work should not be significantly impaired even by the periodic occurrence of paroxysmal AF. Yet sometimes situations arise, like the question of driving, which must be further discussed with your doctor.
Frequently asked questions of patients on paroxysmal AF
- Is it possible to have sex if there is an OP?
People should be able to enjoy all their daily opportunities. While a prolonged load may be associated with an exacerbation of paroxysmal AF, moderate stress is quite acceptable. Therefore, this issue should be discussed with your doctor, who, knowing the specific situation of the patient, will be able to advise the permissible level of stress on the heart.
In most cases, regular sexual activity can be beneficial for the heart, further helping to relieve stress.
- Can I drive a car?
This is allowed, but sometimes paroxysmal AF may cause dizziness or loss of concentration, so you should always first consult a doctor who is knowledgeable about the individual characteristics of the patient.
If during the drive you have to experience symptoms of AF, you need to park as soon as possible or go to a safe area on the road.
- Is it possible to still drink alcohol and caffeine?
Moderate alcohol consumption is permissible, but, as a rule, it is difficult to stop at a little, therefore, in order to avoid drinking excessive amounts of alcohol, it is better to refuse it altogether. It is recommended that people strive to have at least 2-3 days a week completely free from alcohol.
With caffeinated beverages, such as tea, coffee, and energy, there is not yet convincing evidence to prevent them from taking OP. However, frequent use of caffeine can cause an increase in blood pressure, which is directly related to AF.Thus, caffeine intake is recommended to limit to a moderate amount.
- Can I travel?
If paroxysmal AF is well treatable and in a stable condition, there is no reason why it is not allowed to travel or fly.However, before each trip you need to check with your doctor your condition, as extreme temperature transition and high altitude can cause problems. Before traveling, you must make sure that there is enough medicine for the entire period of the trip.
- How can paroxysmal AF change over time?
If symptoms continue for more than a week, the condition is characterized as permanent AF. Treatment of this type of rhythm disorder is extremely problematic, since cardiac activity may not recover.
Video Understanding Atrial Fibrillation
1. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64:e1.
2. Dewland TA, Vittinghoff E, Mandyam MC, et al. Atrial ectopy as a predictor of incident atrial fibrillation: a cohort study. Ann Intern Med 2013; 159:721.
3. Lin WS, Tai CT, Hsieh MH, et al. Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy. Circulation 2003; 107:3176.
Attack of an arrhythmia, characterized by occurrence and termination without visible reasons. During heartbeat, heart rate can reach 300 beats per minute. There are distinct ventricular, atrial and nodular (atrioventricular) forms of the disease. Virtually all pathologies require medical correction.
Tachycardia may develop in the most inappropriate case where the most unexpected symptoms are expected. At high risk of frequent attacks physicians often appoint suitable antiarrhythmic drugs. But even the sick most need to know thoroughly the basic stages of first aid, either alone to provide it to themselves, or to ask about her closest person
First of all, the wrong rhythm is translated into sinus. For this purpose, an electrical or medicinal cardioversion is used with such drugs as propafenone, amiodarone, nibentan, procaineamide. Next, doctors choose one way out of two possible – control of heart rate while maintaining arrhythmia or strategy of rhythm control. In the treatment of atrial fibrillation, anticoagulant therapy is important, which helps to avoid thromboembolism of the arteries of the internal organs and the brain. If medical treatment proved to be ineffective then radiofrequency ablation is used. Cryoablation is also practiced. Antirecurring treatment is based on beta-blockers (metoprolol, bisoprolol, and carvedilol).