Atrial Fibrillation

Normal hearts beat regularly as there is a regular discharge of electrical impulse from a single site in the right upper chamber of heart. Whereas in Atrial fibrillation, multiple electrical impulses simultaneously arise from upper chambers of heart which makes the heart beat fast and irregular and pulse becomes chaotic.

Well, you seem to be nature lover!

Let me guess, your aunt is 70 yrs old, has long standing hypertension, a bit obese and has asthma too.

No, not at all. This is a very typical subset for those suffer Atrial fibrillation. Others may be having heart valve disease, poor heart function, heart failure, previous heart attack, and diabetes or thyroid problems.

Yes, indeed! It is the most common rhythm abnormality worldwide doctors see in their practice.

Just like how we get tired after running, the heart also starts beating faster and irregular leading to Heart Failure. These patient's experience rapid breathing, fatigue, and exercise intolerance, at lesser levels they may feel dizzy / giddy because of low blood pressure and fraction of them can actually fall down unconscious (syncope).

Not all, in many people the heart rate is not that fast and they simply present with palpitations.

Not at all, some of them can land in serious brain stroke.

During AF the upper two chambers of the heart beat very fast up to 400 times a minute. This leads to uneffective emptying of the chambers. The blood whirls around which can form a clot and if that clot migrates to the brain, it can cause a brain stroke.

No, few of them whose heart rates are not very high and who are younger and healthy may not experience any trouble.

ECG confirms the diagnosis. An Echocardiogram (2DECHO cardiogram / heart scan), few blood tests including thyroid and sometimes coronary angiogram and cardiac MRI are required.

Yes, but only in few of them. In the rest, we may not make the rhythm regular but we have plenty of drugs to decrease the heart rate.

No, they aren't harmful. They are life saving medications with a potential to bleed very rarely. Doctors estimate the need for the blood thinner (anticoagulant), the risk of bleeding and after careful evaluation of risk benefit ratio, and educate the family thoroughly too. With NOACs (Novel oral anticoagulants) the safety has significantly improved. Debilitating brain strokes mostly prevented.

We can offer catheter based radiofrequency ablation which may cure her condition and she need not take medicines lifelong.

No, its not surgical procedure. The chest is not cut open for this. All we do is send a long electrical wire from leg vein and apply radio frequency energy in upper heart chambers so the rhythm becomes normal again.

Oh, then thats a good news for her and peace to us as well. Thank you for the information, Dr. Heart.