Paroxysmal Atrial Fibrillation: How to Treat It?

What is Atrial Fibrillation?

Atrial fibrillation is a condition where the heart rhythm becomes irregular and often fast, which can cause symptoms such as irregular heartbeat, fatigue, and shortness of breath. Treating this condition is crucial as it can lead to heart attacks or heart failure and negatively impact quality of life. Individuals with atrial fibrillation have a five to seven times increased risk of developing blood clots and having a stroke, as well as two to three times the likelihood of developing a paroxysmal form of atrial fibrillation. Fortunately, paroxysmal atrial fibrillation can be treated in several ways, including medication, cardioversion (a special electric shock), catheter ablation, or surgical ablation.

What are the Types of Atrial Fibrillation and Common Symptoms?

Types of Atrial Fibrillation

Atrial fibrillation can be of different types:

• Paroxysmal (occasional): In paroxysmal atrial fibrillation, the duration can range from a few minutes to several days, but it eventually resolves spontaneously;
• Persistent atrial fibrillation does not resolve spontaneously but can be treated with medication or a special electric shock (cardioversion) to restore a normal heart rhythm;
• Permanent or chronic. In this situation, atrial fibrillation persists at all times and does not resolve following medical treatment or cardioversion;

Symptoms of Atrial Fibrillation

In some cases, atrial fibrillation involves the appearance of the following symptoms:

• Feeling generally tired, weak;
• Tachycardia, heart beating too fast or strangely, palpitations;
• Feeling like the heart is in the throat;
• Feeling like the heart is "jumping out of the chest";
• Dizziness;
• Feeling of tightness in the middle of the chest, anxiety;
• Shortness of breath, air hunger, dyspnea;
• Episodes of syncope (sudden fainting);
• Excessive fatigue during physical activity, or more generally in case of stress;
• Excessive sweating;
• Chest pain;

What are the Causes and Risk Factors Associated with Atrial Fibrillation?

Atrial fibrillation is a disorder resulting from a failure of the sinoatrial node, itself caused by various factors. Some are related to age and lifestyle, while others may be due to a congenital heart anomaly, such as an unexplained enlargement of the atrium. Sometimes, this defect may even originate in one of the cardiac veins, such as the large pulmonary veins.

There are certain risk factors that can increase the likelihood that our sinus rhythm becomes permanently irregular, as is the case with chronic atrial fibrillation:

• Dealing with other heart conditions, such as cardiomyopathy or congenital heart disease, can be a real ordeal;
• Having suffered from heart attacks;
• Suffering from high blood pressure;
• Suffering from thyroid disease (especially hyperthyroidism);
• Suffering from lung disease;
• Having had infectious viral diseases;
• Being very stressed (psychological causes of atrial fibrillation);
• Being overweight or obese;
• Suffering from diabetes;
• Suffering from obstructive sleep apnea;
• Given that there are often drugs consumed, a strong tendency to drink alcohol and caffeine, as well as the taking of certain medications such as antihistamines or nasal decongestants;

Furthermore, men over 60, women in menopause, and anyone with a family history of this type of heart rhythm abnormality are more likely to suffer from arrhythmias such as atrial fibrillation. Indeed, in the development of cardiovascular disorders, the genetic and hereditary factor plays a major role. For this reason, young people and even children suffering from heart diseases or malformations, In particular, cardiomyopathies, valvular diseases and Wolff-Parkinson-White syndrome (WPW) can be very worrying. Indeed, the congenital pathology that mainly affects young people and manifests as paroxysmal supraventricular tachycardia. Unfortunately, these young people are not immune to atrial fibrillation, which can be extremely dangerous in this case. Indeed, it can lead to ventricular fibrillation, which can have dramatic consequences.

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What is the Diagnosis of Atrial Fibrillation?

What is the diagnostic procedure for atrial fibrillation? The initial and most basic diagnostic tool is the ECG, or electrocardiogram, which analyzes the electrical activity of the heart. This procedure becomes even more reliable if performed under stress, measuring the sinus rhythm during walking on a treadmill or cycling on an exercise bike. It is possible to perform another type of ECG known as dynamic Holter ECG. This technique involves attaching a portable electrocardiograph to the subject to be tested, either on the wrist or arm, and wearing it for 24 to 72 hours while carrying out daily activities. Once the test is complete, the cardiologist examines the variations in heart rate recorded in the device's memory, both at rest and during exertion.

What are the Different Therapies and Treatments Available for Atrial Fibrillation?

Anticoagulant Treatment

For individuals with atrial fibrillation and at high risk, it is essential to follow oral anticoagulant therapy to minimize the dangers of thromboembolic complications such as stroke. Before, patients had to regularly go to medical centers to receive their treatment, with monthly visits and weekly drug dosages. This constraint is no longer necessary for the group of eligible patients, thanks to the new oral anticoagulants.

Treatment with Antiarrhythmic Drugs

For other patients who do not present such a serious picture, explains the doctor, it is advisable to undertake specific pharmacological treatment with antiarrhythmic drugs, which vary from one patient to another.

Atrial Fibrillation Intervention: Minimally Invasive Procedure

When cardiac arrhythmia occurs regularly, a minimally invasive solution is to opt for catheter ablation of atrial fibrillation, a percutaneous intervention. This surgery-free method involves inserting a catheter into the venous system to the heart. The catheter is used to cauterize targeted areas in the left atrium, thus providing a definitive solution for the arrhythmia.

In Conclusion

Paroxysmal atrial fibrillation can be a challenging heart rhythm to treat, as it can become chronic. Treatment options include the use of anticoagulant medications, anti-arrhythmic medications, and minimally invasive catheter ablation.

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