Atrial Fibrillation. Damage to your heart caused by a heart attack or rheumatic heart disease

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1 Atrial Fibrillation GENERAL INFORMATION: What is atrial fibrillation? Atrial fibrillation is a condition that causes the atria (top chambers of the heart) to shake or quiver. Normally, there is 1 contraction for every heartbeat. Atrial fibrillation causes more than one contraction for every heartbeat. Less blood is pushed into the lower chambers. The heart may not be able to fill with enough blood to provide good circulation with every heartbeat. Your atrial fibrillation may come and go, last for only a short time, or be a long-term condition. What causes atrial fibrillation? The cause may not be known. You may be more likely to have atrial fibrillation if you are male, older than 60, or have a family member with it. Alcohol and nicotine from cigarettes may trigger your atrial fibrillation. Atrial fibrillation may also be caused by the following: Blood clots in the lung, or other lung diseases Damage to your heart caused by a heart attack or rheumatic heart disease Hardening of the arteries around your heart (coronary artery disease) Heart failure, an enlarged heart, or heart surgery High blood pressure Problems with your heart valves Thyroid disease, diabetes, or sleep apnea What are the signs and symptoms of atrial fibrillation? Thumping, racing, or skipping heartbeats Feeling unusually tired or weak Feeling dizzy or like you are going to faint Shortness of breath

2 Chest pain or tightness Nausea How is atrial fibrillation diagnosed? Your caregiver will ask about your medical history and examine you. Tell him about your symptoms. You may also need any of the following tests: Blood and urine tests: Samples of your blood and urine are tested to check the levels of salts and minerals. ECG: This is also called an EKG. An ECG is done to check for damage or problems in your heart. A short period of electrical activity in your heart is recorded. Holter monitor: A Holter monitor is also called an ambulatory ECG monitor. It is a device that you wear while you do your usual activities. The monitor shows your heart's electrical activity, how fast it beats, and if it beats in a regular pattern. Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart. Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs. How is atrial fibrillation treated? The goal of treatment is to get your heart back into a normal rhythm and rate. You may need any of the following: Medicines: Antiarrhythmias: These help slow your heartbeat and make it more normal. Beta blockers: These help keep your heartbeat in a regular rhythm. Calcium channel blockers: These help slow your heartbeat. Blood thinners: These help prevent blood clots. Clots can lead to stroke, heart attack, and death. Aspirin is a type of blood thinner. You may need to take an aspirin each day to help prevent blood clots. Do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take. If you are on other blood thinner medicine, ask your caregiver before you take aspirin for any reason. Electrolytes: You may be given electrolytes in the hospital if an electrolyte imbalance caused your atrial fibrillation. Cardioversion: This is a procedure where an electric shock is given to your heart. The shock is usually given through paddles or sticky patches placed on your chest or back. The shock helps your heart return to a normal beat. Cardioversion may be needed if medicine does not make your heart work better. You may need a cardioversion if your heart rhythm is making you sick or is dangerous. You may be given medicine to help you relax before getting the electric shock. If the shock works,

3 your heart rate and rhythm will return to normal. Medicine may be needed to keep your heart in a normal rhythm. You may need a cardioversion more than once. Cardiac ablation: Cardiac ablation is a procedure that uses heat energy to stop abnormal heart impulses. A wire is guided to your heart through an artery or a vein. Your caregiver finds the area of the heart that is causing the problems and applies heat energy to it. This may help your heart beat in a more normal rhythm. Pacemaker: This is a machine that helps your heart beat at a normal speed and in a regular rhythm. If your heart does not beat as it should, the pacemaker sends small electric signals to your heart. You may feel these signals. Temporary: Large patches are placed on your chest and back. The patches are connected to a monitor. Your caregiver may need to put small wires through your skin and into your heart muscle instead. The wires are then connected to a small pacemaker box outside of your body. Permanent: A permanent pacemaker is about the size of a wristwatch. It is implanted under the skin of your chest. Implanted cardioverter defibrillator: An implanted cardioverter defibrillator is also called an ICD. It is a small device that monitors your heart rate and rhythm. If your ICD senses that your heart is beating in an unhealthy rhythm, it will give your heart a small electrical shock. This helps your heart start beating normally again. An ICD is made up of a generator and leads (thin, flexible wires that attach to your heart). The generator and the leads will be placed inside you during a procedure. The generator has a metal shell with a battery and a small computer inside. Maze surgery: A surgeon makes many incisions into the heart muscle. These incisions create a maze-like new path for the heart impulses to travel. This helps your heart beat in a more regular rhythm. What are the risks of atrial fibrillation? Without treatment, your body may not get the oxygen it needs. You have an increased risk of a heart attack or heart failure. The shaking motion causes blood to pool in the chambers. This pooling may allow blood clots to form. Clots may travel to your lungs or brain. This can be life-threatening. When should I contact my caregiver? Contact your caregiver if: You are short of breath, even at rest. You have new or worsening swelling in your feet or ankles. You have questions or concerns about your condition or care. When should I seek immediate care? Seek care immediately or call 911 if:

4 You have pain, pressure, or fullness in your chest that lasts more than a few minutes or returns. You have pain or discomfort in your back, neck, jaw, stomach, or arm. You have an upset stomach. You have a sudden cold sweat. You suddenly feel lightheaded and are short of breath. You have more pain when you take deep breaths or cough. You cough up blood. You have a painful red lump in your arm or leg. You have weakness or numbness in your arm, leg, or face. You are confused or have problems speaking or understanding speech. You have a severe headache or feel dizzy. You have vision changes or loss of vision. CARE AGREEMENT: You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. GENERAL INFORMATION: Atrial Fibrillation What is atrial fibrillation? Atrial fibrillation is a condition that causes the atria (top chambers of the heart) to shake or quiver. Normally, there is 1 contraction for every heartbeat. Atrial fibrillation causes more than one contraction for every heartbeat. Less blood is pushed into the lower chambers. The heart may not be able to fill with enough blood to provide good circulation with every heartbeat. Your atrial fibrillation may come and go, last for only a short time, or be a long-term condition. What causes atrial fibrillation? The cause may not be known. You may be more likely to have atrial

5 fibrillation if you are male, older than 60, or have a family member with it. Alcohol and nicotine from cigarettes may trigger your atrial fibrillation. Atrial fibrillation may also be caused by the following: Blood clots in the lung, or other lung diseases Damage to your heart caused by a heart attack or rheumatic heart disease Hardening of the arteries around your heart (coronary artery disease) Heart failure, an enlarged heart, or heart surgery High blood pressure Problems with your heart valves Thyroid disease, diabetes, or sleep apnea What are the signs and symptoms of atrial fibrillation? Thumping, racing, or skipping heartbeats Feeling unusually tired or weak Feeling dizzy or like you are going to faint Shortness of breath Chest pain or tightness Nausea How is atrial fibrillation diagnosed? Your caregiver will ask about your medical history and examine you. Tell him about your symptoms. You may also need any of the following tests: Blood and urine tests: Samples of your blood and urine are tested to check the levels of salts and minerals. ECG: This is also called an EKG. An ECG is done to check for damage or problems in your heart. A short period of electrical activity in your heart is recorded. Holter monitor: A Holter monitor is also called an ambulatory ECG monitor. It is a device that you wear while you do your usual activities. The monitor shows your heart's electrical activity, how fast it beats, and if it beats in a regular pattern. Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart. Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

6 How is atrial fibrillation treated? The goal of treatment is to get your heart back into a normal rhythm and rate. You may need any of the following: Medicines: Antiarrhythmias: These help slow your heartbeat and make it more normal. Beta blockers: These help keep your heartbeat in a regular rhythm. Calcium channel blockers: These help slow your heartbeat. Blood thinners: These help prevent blood clots. Clots can lead to stroke, heart attack, and death. Aspirin is a type of blood thinner. You may need to take an aspirin each day to help prevent blood clots. Do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take. If you are on other blood thinner medicine, ask your caregiver before you take aspirin for any reason. Electrolytes: You may be given electrolytes in the hospital if an electrolyte imbalance caused your atrial fibrillation. Cardioversion: This is a procedure where an electric shock is given to your heart. The shock is usually given through paddles or sticky patches placed on your chest or back. The shock helps your heart return to a normal beat. Cardioversion may be needed if medicine does not make your heart work better. You may need a cardioversion if your heart rhythm is making you sick or is dangerous. You may be given medicine to help you relax before getting the electric shock. If the shock works, your heart rate and rhythm will return to normal. Medicine may be needed to keep your heart in a normal rhythm. You may need a cardioversion more than once. Cardiac ablation: Cardiac ablation is a procedure that uses heat energy to stop abnormal heart impulses. A wire is guided to your heart through an artery or a vein. Your caregiver finds the area of the heart that is causing the problems and applies heat energy to it. This may help your heart beat in a more normal rhythm. Pacemaker: This is a machine that helps your heart beat at a normal speed and in a regular rhythm. If your heart does not beat as it should, the pacemaker sends small electric signals to your heart. You may feel these signals. Temporary: Large patches are placed on your chest and back. The patches are connected to a monitor. Your caregiver may need to put small wires through your skin and into your heart muscle instead. The wires are then connected to a small pacemaker box outside of your body. Permanent: A permanent pacemaker is about the size of a wristwatch. It is implanted under the skin of your chest. Implanted cardioverter defibrillator: An implanted cardioverter defibrillator is also called an ICD. It is a small device that monitors your heart rate and rhythm. If your ICD senses that your heart is beating in an unhealthy

7 rhythm, it will give your heart a small electrical shock. This helps your heart start beating normally again. An ICD is made up of a generator and leads (thin, flexible wires that attach to your heart). The generator and the leads will be placed inside you during a procedure. The generator has a metal shell with a battery and a small computer inside. Maze surgery: A surgeon makes many incisions into the heart muscle. These incisions create a maze-like new path for the heart impulses to travel. This helps your heart beat in a more regular rhythm. What are the risks of atrial fibrillation? Without treatment, your body may not get the oxygen it needs. You have an increased risk of a heart attack or heart failure. The shaking motion causes blood to pool in the chambers. This pooling may allow blood clots to form. Clots may travel to your lungs or brain. This can be life-threatening. When should I contact my caregiver? Contact your caregiver if: You are short of breath, even at rest. You have new or worsening swelling in your feet or ankles. You have questions or concerns about your condition or care. When should I seek immediate care? Seek care immediately or call 911 if: You have pain, pressure, or fullness in your chest that lasts more than a few minutes or returns. You have pain or discomfort in your back, neck, jaw, stomach, or arm. You have an upset stomach. You have a sudden cold sweat. You suddenly feel lightheaded and are short of breath. You have more pain when you take deep breaths or cough. You cough up blood. You have a painful red lump in your arm or leg. You have weakness or numbness in your arm, leg, or face. You are confused or have problems speaking or understanding speech. You have a severe headache or feel dizzy. You have vision changes or loss of vision. CARE AGREEMENT: You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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