Atrial fibrillation: Treat it or pay the price

The most common abnormal heart rhythm is atrial fibrillation and involves the atria, or the heart’s two upper chambers.

Its name comes from the fibrillating, or quivering, of the heart muscles in the atria.

This was the opening topic Thursday of the 20th season of heart lectures at Canoa Hills Social Center, where Dr. Peter Ott of University Medical Center’s Sarver Heart Center spoke to an audience of about 175.

He said AF results when there is electrical chaos in the upper chambers and the impulses travel to the lower chambers.

“Atrial fibrillation results in a faster and irregular heart rate. It may also result in palpitations, fatigue and shortness of breath... there may be a rapid and irregular pulse and irregular blood pressure.”

The primary causes are aging, hypertension and heart disease. Rare causes include hyperthyroidism, asthma medications and acute alcohol intoxication.

In the U.S. there are about 400,000 hospital admissions for AF generating $6 billion is medical expenditures. Ott said it’s important that AF be treated because it can cause strokes and heart failure. He explained that coumadin/warfarin is an anti-arrhythmic drug. As an anticoagulant or blood thinner it helps reduce formation of blood clots and can help maintain a regular rhythm.

Electrical cardioversion, or shocking the heart back to normal, and a procedure called “nodal catheter ablation” are other options.

“Catheter ablation eliminates fast and irregular heart rates. It’s for those not responding to drugs and it helps reduce doctor and hospital visits.

“This procedure is relatively complex. It’s for patients with very bad symptoms and frequent episodes,” Ott told the audience.

The surgery has a 90 percent success rate with about a five percent complication rate, which includes bleeding and/or a stroke.

“Of 500,000 strokes a year in the U.S. about 120,000 are due to AF. Seventy percent (of the 120,000) end up with severe nerve complications because blood clots travel to the brain,” Ott said.

For those at moderate risk and not taking coumadin/warfarin, there’s a 5 to 8 percent risk for stroke. This is in contrast to 10 to 17 percent for anyone at high risk.

However, if coumadin/warfarin is taken, the risk of stroke is lowered to 1 to 2 percent. Aspirin is prescribed only for those at low risk for stroke.

Ott said AF can be treated with medication, electrical cardioversion or nodal catheter ablation.

“The goal is always to maintain a normal heart rhythm and to prevent a stroke.”

Free Sarver Heart Center lectures are sponsored by Green Valley Recreation and are open to the public. They are held on the third Thursday of the month at Canoa Hills Social Center, 3600. S. Camino del Sol.

Ellen Sussman is a freelance writer in Green Valley. Contact her at ellen2414@cox.net.

UPCOMING LECTURES

Nov. 19: How You Can Prevent a Stroke

Dec. 17: Heart Disease in Women: “Apples” and “Pears”

Jan. 21: The Epidemic of Obesity and Diabetes

Feb. 18: What’s New in Heart Disease Prevention

March 18: Cutting-Edge Technology in Heart Disease Diagnosis and Treatment