Atrial fibrillation A-fib is the most common form of heart arrhythmia in the United States. To diagnose A-fib, doctors may perform several assessments, from physical examinations to ultrasound imaging.
In addition to looking for signs of A-fib, doctors may check for underlying conditions that can cause arrhythmia and any resulting complications. Sometimes, a general practitioner will refer a person to a cardiologist, who is a specialist in heart disease. In this article, we look at the procedures and tests that doctors use to confirm a diagnosis of A-fib and identify possible causes and complications of the condition.
As an initial assessment, a doctor will ask a person about their medical history. This will include questions about A-fib symptoms and their frequency, and questions about other risk factors. In addition, the doctor may ask about eating and exercise habits, alcohol consumption, and any tobacco or recreational drug use. They may also ask about a family history of A-fib. This is because people who have relatives with A-fib may have an increased risk of developing the condition.
Answering these questions can help the doctor identify any potential signs of A-fib or another condition and assess the overall risk. The clearest physical sign of A-fib is an irregular heart rhythm. They can also listen to the rhythm and rate of heartbeats with a stethoscope. As part of the examination, the doctor will assess other physical markers that may indicate a problem with heart function.
They may measure blood pressure, check for heart murmurs, and look for evidence of heart failure. The doctor will also look for signs of health conditions that can cause or contribute to A-fib, such as hyperthyroidism, which is an overactive thyroid gland. Learn more about hyperthyroidism here. To diagnose A-fib, find its most likely cause, and identify any complications, a doctor may order:.
An electrocardiogram: An electrocardiogram EKG records the electrical activity of the heart. During an ECG, small stickers called electrodes are attached to your arms, legs and chest, and connected by wires to an ECG machine. Every time your heart beats, it produces tiny electrical signals. An ECG machine traces these signals onto paper. During an episode of atrial fibrillation, your heart rate will be irregular and over beats per minute. If you have an episode of atrial fibrillation during an ECG, your abnormal heart rate will be recorded.
Cardiac ablation uses heat radiofrequency energy or extreme cold cryoablation to create scars in your heart to block abnormal electrical signals and restore a normal heartbeat. A doctor inserts a flexible tube catheter through a blood vessel, usually in your groin, and into your heart. More than one catheter may be used. Sensors on the tip of the catheter apply the cold or heat energy.
There are different types of cardiac ablation. The type used to treat atrial fibrillation depends on your specific symptoms, overall health and whether you're having another heart surgery. For example, some of the types of cardiac ablation that may be used to treat atrial fibrillation are:.
Maze procedure. A doctor uses heat or cold energy or a scalpel to create a pattern of scar tissue the maze in the upper chambers of the heart.
Because scar tissue doesn't send electrical signals, the maze interferes with the stray heart signals that cause atrial fibrillation. If a scalpel is used to create the maze pattern, open-heart surgery is necessary. This is called the surgical maze procedure. It's the preferred method of atrial fibrillation treatment in those who need another heart surgery, such as coronary artery bypass surgery or heart valve repair.
Atrial fibrillation may return after cardiac ablation. If this happens, another cardiac ablation or other heart treatment may be recommended. After cardiac ablation, lifelong blood thinners may be needed to prevent strokes. If a person with A-fib can't take blood-thinning medications, a doctor may recommend a catheter procedure to seal a small sac appendage in the left upper heart chamber, where most A-fib related clots form.
This procedure is called left atrial appendage closure. A closure device is gently guided through a catheter to the sac. Once the device is in place, the catheter is removed.
The device is left permanently in place. Surgery to close the left atrial appendage is an option for some people already having heart surgery. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Following a heart-healthy lifestyle can help prevent or treat conditions such as high blood pressure and heart disease.
Lifestyle changes often include:. If you have an irregular or pounding heartbeat, make an appointment with your family doctor. If atrial fibrillation is found early, treatment may be easier and more effective. You may be referred to a doctor trained in heart conditions cardiologist. Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be prepared for your appointment.
Here's some information to help you get ready for your appointment, and what to expect from your doctor. Your doctor will also discuss which medication may be right for you. There are two general classes of anticoagulant that can be taken in tablet form: non-vitamin K oral anticoagulants NOACs or warfarin. These medications reduce the chances of a stroke by about two-thirds. NOACs work by slowing down the body's natural clotting process.
When compared with warfarin , NOACs have two main benefits:. You will need to tell your doctor about any other prescribed medication, complementary or herbal medicines, and or recreational drugs before starting a NOAC. You should avoid heavy drinking when taking NOACs. Warfarin works by blocking the body's clotting process. Normally the body uses vitamin K to produce 'clotting factors' substances which help the body control bleeding. Warfarin interferes with this use of vitamin K, which in turn stops the blood from clotting so quickly.
One downside of warfarin is that other medications and diet can reduce its efficacy ability to work.
This means you'll need to talk to your doctor about any other prescription or recreational drugs you may be taking and any complementary medicine or herbal remedies. You may also have to avoid some foods, particularly those high in vitamin K, such as green leafy vegetables like spinach and broccoli.
Large quantities of alcohol may also have a negative effect. You will need to have regular blood tests to monitor the time it takes for your blood to clot your INR level. Often it takes a while for the doctor to get the right dose. If you make changes to your diet or start taking other drugs, this may have an impact on your INR levels. The main side effect of starting any type of anticoagulant is increased bleeding and bruising.
Patients taking NOACs may also experience stomach side effects such as indigestion heartburn. It is very important that you tell your dentist or surgeon that you're taking an anticoagulant before you receive any kind or dental or surgical treatment. While anticoagulants lower your risk of stroke, they don't remove all risk. It's important that you are aware of the signs of a stroke and if you notice any, you call immediately. Sometimes your doctor may recommend a surgical procedure called a left atrial appendage closure to reduce your risk of stroke.
During the procedure, doctors close off a small sac in the left atrium upper chamber of the heart , called the left atrial appendage.
The procedure reduces your risk of stroke because many blood clots caused by atrial fibrillation form in the left atrial appendage. This procedure may be suitable for people without heart valve problems who have an increased risk of bleeding but are aren't able to take anticoagulants. As well as reducing your risk of stroke, AF treatment may needed to help manage your symptoms. This may be done by:. Slowing your heart rate can relieve symptoms even if you still have an irregular heart rhythm. In the first instance doctors will usually try medication to slow your heart rate down.
Common types include:.
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