Electrophysiology Procedures

What is Atrial Fibrillation?


Atrial Fibrillation (or AF, for short) is the commonest Heart Rhythm Disorder. So what is a Heart Rhythm Disorder? Well, our heart is mostly a Muscle, but we are also born with an Electrical System that tells the muscle how fast to beat. When this electrical system goes bad, it is called an Arrhythmia (or Heart Rhythm Disorder).

People with this condition can experience palpitations (or pounding of the heart), irregular heart beats, dizziness, lightheadedness, fainting (syncope), chest pains, shortness of breath, fatigue/feeling tired etc.

There are many types of arrhythmias depending on which specific part of the heart they start in. The commonest arrhythmia is known as Atrial Fibrillation or A Fib or simply AF, and it starts in the Left Upper Chamber of the heart (or Left Atrium), around veins known as Pulmonary Veins. In A Fib, the upper chambers of the heart (the Atria) beat very fast and irregular, driving the lower chambers of the heart (the Ventricles) to go fast and irregular. Other types of arrhythmias are called Atrial Flutter, Supraventricular Tachycardia (or SVT), Ventricular Tachycardia (or VT), Wolf Parkinson White syndrome (or WPW) etc.


Medicines for A Fib



  • Blood Thinners
Blood Thinners

Depending on your “risk factors” for stroke, you will be asked by your doctor to take a blood thinner. Some patients may only need an aspirin daily. Most patients will be advised to take warfarin or coumadin, or one of the newer blood thinners such as dagibatran, apixaban etc. If you take coumadin, you will need frequent blood tests to regulate it. The newer blood thinners do not need blood tests, but depending on your insurance plan, may be expensive to buy.



  • Rhythm Control Medicines
Rhythm Control Medicines

These are “stronger” medicines such as propafenone, amiodarone, flecainide, sotalol, dofetilide, dronedarone etc. Their role is to try to keep you in normal sinus rhythm (or prevent you from going into a fib). They may be combined with a cardioversion or ablation, in an attempt to keep you in normal rhythm. However, they could have serious side effects and need to be monitored closely by your cardiologist.



  • Rate Control Medicines
Rate Control Medicines

Medicines such as beta blockers (e.g. metoprolol, atenolol etc) or calcium channel blockers (e.g. diltiazem, verapamil etc) or digoxin may be used to control the speed of your heart. However, these medicines generally do not help your heart to convert out of A Fib. In other words, you remain in A Fib, but your pulse (although still irregular), will be slower. This may help you feel a little better, but since you are still in A Fib, most patients still may experience some symptoms.


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