How to deal with a trial fibrillation - rapid or irregular heartbeat

Rapid heartbeat needs attention

PUBLISHED : Monday, 11 August, 2014, 9:39am
UPDATED : Monday, 11 August, 2014, 9:39am

Many people have experienced heart palpitations - a feeling that your heart is beating too hard or too fast. In most cases these palpitations are neither serious nor harmful, but they can give you a scare. Usually, they are caused either by stress and anxiety or after participating in sports. Generally, there is nothing to worry about.

But some may suddenly feel their heartbeat increase or become irregular and this can continue for a while. This condition could be a symptom of atrial fibrillation (AF or A-Fib), which needs immediate medical diagnosis. Leaving it unresolved means the risk of a stroke is increased twofold.

Atrial fibrillation is the most common abnormal heart rhythm and is sometimes referred to as quivering heart. It can lead to blood clots, a stroke, heart failure and other heart-related complications.

Leaving atrial fibrillation unresolved means the risk of a stroke is increased twofold

It's a degenerative disease that ordinarily affects older people. But people with high blood pressure, thyroid diseases, structural heart disease and those who are overweight are an increased risk of AF.

People who show symptoms of AF may experience palpitations, lower blood pressure, weakness, dizziness, confusion, shortness of breath, or feel dull chest pains.

There are three types of AF, which are categorised depending on the frequency of recurrence:

  • Paroxysmal AF (occasional) - symptoms vary in duration, lasting just a matter of seconds in some cases, but they can persist for longer. This type of AF occurs when faulty electrical signals and rapid heart rate begin suddenly and then stop on their own. The symptoms can be either mild or severe and generally cease, without treatment, within seven days.
  • Persistent AF - this occurs when the abnormal heart rhythm continues for more than a week. It may stop on its own, but it is more likely to come to an end when the patient receives treatment.
  • Permanent AF - this type of AF has usually persisted for more than a year and occurs when normal heart rhythm cannot be restored with usual treatment. If paroxysmal and persistent AF become more frequent they can develop into permanent AF.

Paroxysmal means it comes and goes on its own within seven days. If it lasts longer it's considered persistent. These two types can be controlled with medication. But permanent sufferers may need surgery to correct the problem because the heartbeat irregularity will not go away on its own.

In terms of using medicines, there are two goals of treatment for AF - control the heart rate and restore a normal heart rhythm:

  • Rate control - this involves controlling how many times a minute the ventricles contract. Rate control does not prevent abnormal heart rhythm, but it is important because it allows patients to feel better and have fewer symptoms because the ventricles are given enough time to completely fill with blood.
  • Rhythm control - this restores a normal heart rhythm by allowing the atria and ventricles to work together to efficiently pump blood to the body.

Both will help alleviate the symptoms brought on by AF and have achieved ideal results in most patients.

Doctors will also prescribe patients with oral anticoagulant - commonly known as blood thinning medicines - preventing blood clots from forming and thus lower the risk of a stroke.

Patients should never stop medication without the approval of a doctor, otherwise the result could be life threatening.

Dr Anders Leung is a Hong Kong-based specialist in cardiology