Paroxysmal atrial fibrillation

Definition

• Atrial fibrillation, often called AFib or AF, is the most common type of treated heart arrhythmia. Paroxysmal atrial fibrillation refers to the short bursts of atrial fibrillation as opposed to chronic atrial fibrillation.

ECG Atrial Fibrillation

• It usually stops in less than 24 hours but may last up to a week. Paroxysmal atrial fibrillation can happen repeatedly.

• You may need treatment or your symptoms may go away on their own.

Tachybrady syndrome

• When this kind of atrial fibrillation alternates with a heartbeat that is slower than normal, it is called tachybrady syndrome.

Causes

• Changes to the heart’s tissue and to its electrical signals most often cause atrial fibrillation.
• When the heart’s tissue or signaling is damaged, the regular pumping of the heart muscle becomes fast and irregular.
• Damage to the heart is the result of other conditions such as high blood pressure and ischemic heart disease.
• Other factors can also raise your risk of atrial fibrillation.

Symptoms

• Symptoms vary and some are asymptomatic while others may experience:

• Irregular heartbeat
• Heart palpitations
• Lightheadedness
• Extreme fatigue
• Shortness of breath
• Chest pain

Risk factors

• The risk for AFib increases with age. High blood pressure, the risk for which also increases with advancing age, accounts for about 1 in 5 cases of AFib.

Risk factors for AFib include:

• Advancing age
• High blood pressure
• Obesity
• European ancestry
• Diabetes
• Heart failure
• Ischemic heart disease
• Hyperthyroidism
• Chronic kidney disease
• Moderate to heavy alcohol use
• Smoking
• Cardiomegaly, especially left side of the heart

Signs and symptoms

The most common symptom of atrial fibrillation is fatigue. Other signs and symptoms include:

• Heart palpitations
• Difficulty breathing, especially when lying down
• Chest pain
• Low blood pressure
• Dizziness or fainting

Diagnosis

• Medical history
• Physical examination

Diagnostic tests

• Order 12 lead EKG first to record your heart’s electrical activity.

If the patient has a pacemaker, check data from a pacemaker or implanted defibrillator may also be helpful.

• Blood tests to check the level of substances in the blood, such as potassium and thyroid hormone.

• Chest X-ray to look for signs of complications from atrial fibrillation, such as fluid buildup in the lungs or a heart that is larger than normal.
• Electrophysiology study (EPS) to record your heart’s electrical signals
• Holter and event monitors to record your heart’s electrical activity over long periods of time
• Loop recorder to record the heart’s electrical activity.
• Sleep study to see if sleep apnea is causing your symptoms.
• Stress test or exercise stress test to look at changes in your heart’s activity.
• Transesophageal echocardiography (TEE) to detect blood clots that may be forming in the heart’s upper chambers because of atrial fibrillation.
• Walking test to measure your heart activity while you walk for six minutes. This can help determine how well your body can control your heart rate under normal circumstances.

Treatment

• Lifestyle changes
• - Atrial Fibrillation
• Heart-healthy eating patterns such as the DASH eating plan, which reduces salt intake to help lower blood pressure
• Being physically active
• Getting help if you are trying to stop using street drugs
• Limiting or avoiding alcohol or other stimulants that may increase your heart rate
• Managing stress
• Quitting smoking.

Also see

• Atrial fibrillation

Paroxysmal atrial fibrillation Resources
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