Atrial Fibrillation | Episode 077


Episode summary introduction:

An arrhythmia happens when the electrical impulses in the heart do not work properly and cause the heart to beat irregularly, either too fast, or too slow. Afib is considered to be an tachyarrhythmia, which means the heart is beating too fast. This irregular heartbeat starts in the atria, the top chamber of the heart and is the leading cause of stroke.

Topic 1:

Afib is typically picked up on an ekg, as some patients have symptoms while others do not. When looking at an EKG, a patient with afib typically lacks P waves, their pulse is irregular and they have a narrow QRS complex (less than 120ms).

There are four types of afib; paroxysmal, persistent, long-term persistent, and permanent. The type of atrial fibrillation you have depends on how often it occurs and how it responds to treatment.

Topic 2:

Symptoms

Fatigue

Heart palpitations

Difficulty breathing, especially when lying down

Chest pain

Hypotension (low blood pressure)

Dizziness or fainting

Palpitations are usually more common in paroxysmal AF

Shortness of breath is more common in chronic AF.

Not all types of AF are symptomatic

paroxysmal AF patients are the more asymptomatic

Topic 3:

Treatments

Anti-arrhythmics

Heart rate control

Catheter and surgical procedures

Outro:

One study that we found interesting was a study that looked at 50 post op cardiac surgery patients at Cleveland Clinic.

Patients were provided an Apple Watch 4 at random and provided with instructions on how to activate the heart rhythm reading on the app. There was also an automatically-generated PDF of the waveform on the Apple Health App that was exported and a rhythm strip was saved.

References:

https://www.cdc.gov/heartdisease/atrial_fibrillation.htm

https://www.ncbi.nlm.nih.gov/books/NBK526072/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722728/

https://www.nhlbi.nih.gov/health-topics/atrial-fibrillation

https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767393/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059277/

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/catheter-ablation

https://www.mayoclinic.org/tests-procedures/ep-study/about/pac-20384999

https://www.stopafib.org/surgical-ablation.cfm

https://www.stopafib.org/mini-maze.cfm

https://healthblog.uofmhealth.org/heart-health/treating-afib-av-node-ablation-a-last-resort

https://www.heartcentre.ca/sites/default/files/Ablation%20for%20AVN.pdf

https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/atrioventricular-node-ablation

Study:

https://newsroom.clevelandclinic.org/2020/02/25/cleveland-clinic-studies-accuracy-of-apple-watch-4-for-atrial-fibrillation-detection/

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