James Beckerman, MD, FACC
Do you ever feel like your heart is racing or fluttering, even when you're at rest? It’s often an isolated event for those with a healthy heart. But sometimes these symptoms can be caused by an arrhythmia or heart rhythm disorder.
One common arrhythmia is called atrial fibrillation or AFib. During AFib, the atria -- the smaller chambers that normally pump blood into the larger ventricles -- quiver rapidlyand erratically. This causes the atria not to squeeze blood effectively into the ventricles. It typically results in a rapid and irregular heartbeat.
“Normally, one’s own pacemaker beats at rates between 60 and 100 beats per minute at rest. In contrast, during atrial fibrillation, the atria are being activated at rates in excess of 400 beats per minute in a chaotic electrical pattern,” says Richard L. Page, MD, the George R. and Elaine Love professor and chair in the department of medicine at the University of Wisconsin School of Medicine & Public Health in Madison.
Atrial fibrillation symptoms and signs can include:
Atrial fibrillation may happen occasionally with symptoms that come and go, last for a few minutes to hours, and then stop on its own. With chronic atrial fibrillation, the arrhythmia is always present.
Atrial fibrillation is more common as adults get older. Approximately 11% of individuals over 80 years of ageare affected by this arrhythmia.
In many cases, people suffering from atrial fibrillation do not experience any symptoms. It’s not uncommon for atrial fibrillation to be discovered as the cause after a first stroke for older adults, Page says.
There is a higher risk for stroke if diagnosed with AFib, especially with factors such as heart valve disease, heart failure, diabetes, and hypertension. Blood clots can form in the atria from atrial fibrillation. This can lead to a stroke when the clot leaves the heart and travels to the brain.
Although not as common, teens can also experience symptoms of atrial fibrillation. It can be a single, isolated event or a sign of an underlying condition if repeated episodes follow.
“Unlike in adult patients, it is extremely rare to be diagnosed during a routine evaluation. Pediatric patients are almost always symptomatic with palpitations prior to a serious event such as cardiac arrest,” says Steven Fishberger, MD, a pediatric cardiologist at the NYU Langone Medical Center.
Page tells WebMD that younger patients with normal hearts who experience an isolated incident of atrial fibrillation symptoms are less likely to have the risk factors that can lead to stroke.
A single event of AFib for an otherwise healthy heart can be triggered by drug or alcohol use, or even exercise. Frequently, a teen will describe a sensation of the heart beating rapidly or chest pain and abdominal pain, Fishberger says.
If you experience symptoms of AFib, it's important to see your doctor. Your doctor can identify an irregular heartbeatby checking the pulse or listening to the heart with a stethoscope. Other diagnostic tests include an electrocardiogram (ECG or EKG), which is the most reliable methodto detect and confirm the presence of AFib. If AFib comes andgoes intermittently, your doctor may ask you to wear a monitor or recorder to detect it. You may be asked to wear a Holter monitor or portable event monitor, which allows your doctor to analyze data that is recorded over a certain period of time.
SOURCES:Steven Fishberger, MD, division of pediatric cardiology, NYU Langone Medical Center.Fuster, V. Journal of the American College of Cardiology, March 2011; vol 57: e101-e198.Mayo Foundation for Medical Education and Research: “Atrial fibrillation.”National Institute of Neurological Disorders and Stroke: “Atrial Fibrillation and Stroke Information Page.”Richard L. Page, MD, George R. and Elaine Love professor and chair, department of medicine, University of Wisconsin School of Medicine & Public Health in Madison; chair, American College of Cardiology’s electrocardiogram/electrophysiology committee.Shea, J. Circulation, May 20, 2008; vol 117: e340-e343.
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