NEW HANOVER REGIONAL MEDICAL CENTER Taking Control of Atrial Fibrillation AFIB Patient Guide-2019-CVR-1-4PRINT.indd 3 6/14/19 11:01 AM Leading Our Community to Outstanding Health AFIB Patient Guide-2019-CVR-1-4PRINT.indd 4 6/14/19 11:01 AM Taking Control of Atrial Fibrillation Getting Back on the Beat: Taking Control of Atrial Fibrillation What is Atrial Fibrillation? . 2 Cause of Atrial Fibrillation? . 3 What are the Risk Factors for Developing Atrial Fibrillation? . 3 Types of Atrial Fibrillation? . 4 What are the Symptoms of Atrial Fibrillation? . 4 How is Atrial Fibrillation Diagnosed? . 5 Atrial Fibrillation and Stroke . 7 Treatment Strategies . 9 Related Medical Conditions . 11 Lifestyle Changes . 11 When to Call for Help . 12 My Atrial Fibrillation Action Plan . 13 My Important Numbers . 13 Understanding Afib and Stroke Risk . 14 Understanding My Afib . 15 Notes . 16 1 AFIB Patient Guide-REV-PRINT.indd 1 5/31/19 2:54 PM Taking Control of Atrial Fibrillation What is Atrial Fibrillation? Atrial fibrillation, also known as Afib, is an irregular, fast heartbeat that may cause symptoms like heart palpitations, fatigue, and shortness of breath. At least 2.7 million Americans are living with Afib. What Happens During Afib? Normally, your heart contracts and relaxes to a regular beat. In atrial fibrillation, the upper chambers of the heart (the atria) beat irregularly (quiver). Because of this irregular beat, a blood clot can form. If the blood clot breaks and enters the bloodstream, it could go to the brain and cause a stroke. About 15-20% of people who have strokes have this irregular heart rhythm. Patients with this condition are put on blood thinners to prevent strokes. Afib is a serious condition. If atrial fibrillation is not treated, it doubles the risk of heart-related death and increases the risk of having a stroke by five times. 2 AFIB Patient Guide-REV-PRINT.indd 2 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Cause of Atrial Fibrillation Causes of Afib can be put into two categories; factors that Sometimes, you can control and factors you can’t control. the causes of Afib can Afib Risk Factors be unclear and other times, people with normal hearts You Can Control may develop • High cholesterol Afib. • High blood pressure • Heart disease • Smoking • Excess weight Afib Risk Factors • Caffeine You Can’t Control • Alcohol abuse • Family history • Lack of exercise • Advancing age • Some medications • Heart diseases from birth • Sleep apnea HOW TO REDUCE RISKS? 1 2 3 Improve Treat atrial Know your risk & your overall fibrillation and take risk-lowering health related conditions meds if needed 3 AFIB Patient Guide-REV-PRINT.indd 3 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Types of Atrial Fibrillation Paroxysmal Persistent Afib Afib Paroxysmal Afib – Afib that comes and goes. The episode may last for seconds, minutes, hours, or days before the heart returns to its normal rhythm. As the heart goes in and out of Afib, Atrial your heartbeat may change from slow to fast and back again in short Fibrillation periods of time. Persistent Afib – Afib that does not stop by itself. Medication or a procedure called cardioversion is used to help the heart return to normal rhythm. If no treatment is done, the heart will stay in atrial fibrillation. Permanent Afib – Afib that cannot be corrected. Medications and procedures are not able to return the heart to normal rhythm. You will be given treatment to Permanent control your heart rate and reduce the risk of stroke. Afib What Type of Afib Do I have? Symptoms of Atrial Fibrillation The symptoms of Afib are different for each person. Some people can tell as soon as Afib begins. Other people don’t have any symptoms. 1. Feeling over tired or lacking energy (most common) 2. Having a fast heartbeat 3. Being short of breath 4. Racing or pounding heart 5. Struggling with everyday exercises or activities 6. Feeling pain, pressure, tightness, or discomfort in your chest 7. Feeling dizzy or lightheaded 8. Fainting What are my Afib symptoms? 4 AFIB Patient Guide-REV-PRINT.indd 4 5/31/19 2:54 PM Taking Control of Atrial Fibrillation How is Atrial Fibrillation Diagnosed? There are quite a few tests done when someone has a fast or irregular heartbeat. Your doctor may order one or more of these tests. Electrocardiogram (ECG) – An ECG is a snapshot of your heart’s electrical activity. It is often performed in a doctor’s office. Stickers (electrodes) are attached to your chest, arms and legs. This test measures the rate and rhythm of your heart. Holter monitor – A Holter monitor is a transportable ECG. It is typically worn for 24 to 48 hours. Stickers (electrodes) are placed on your chest and are then connected to a small recording machine. It records the electrical activity of your heart for your doctor to review later. Mobile Cardiac Monitoring – A continuous event monitor that is like a Holter monitor but is worn for up to 30 days. It will trigger a recording when it feels an abnormal rhythm (arrhythmia). The results are automatically sent to your doctor, who uses this information to evaluate your symptoms and determine if they are caused by an abnormal heart rhythm. This type of monitor helps diagnose Afib in patients without symptoms or in patients who have Afib only occasionally. Implantable Loop Recorder – Implantable loop recorders (ILRs) continuously record the heart’s rate and rhythm. It is placed under the skin of the chest, and the battery lasts about three years. It transfers information about your heart’s rate and rhythm to your doctor. ILRs are most commonly used for patients who have an irregular heart rhythm occasionally. Electrocardiogram (ECG) Holter monitor Implantable Loop Recorder 5 AFIB Patient Guide-REV-PRINT.indd 5 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Other Tests Your doctor may order other imaging tests. These tests can help your doctor choose the right treatment plan for you. Echocardiogram – An echocardiogram uses sound waves to take pictures of your heart. There are two types of echocardiograms: Transthoracic Echocardiogram (TTE) – This type of echocardiogram gives your doctor a picture of your beating heart. It is non-invasive, which means nothing goes inside your body. A technician spreads gel on your chest and then moves a device, called a transducer, across your chest. A video then shows the size of your heart and how well your heart and heart valves are working. Transesophageal Echocardiogram (TEE) – A transesophageal echocardiogram, or a TEE, shows a clearer picture of the top chambers of your heart. A probe, called a transducer, is inserted through your mouth and moved down your esophagus (the tube that connects your mouth to your stomach). You will be given medicine to help you relax, and spray is used to numb the back of your throat so you are comfortable during the procedure. This type of echocardiogram is used to get more detail about heart valves and to check for clots that may have formed in the heart. 6 AFIB Patient Guide-REV-PRINT.indd 6 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Atrial Fibrillation and Stroke One of the most serious risks of Afib is the risk of stroke. Afib makes the top chamber of the heart quiver so blood does not flow normally. With the blood moving more slowly, it can form clots. If a clot that forms in the left top chamber of your heart breaks free, it can travel out to your body. If a blood clot travels to the brain, it can cause a stroke. Your doctor will ask you about your medical history to figure out if your Afib increases your risk of having a stroke. If you are at increased risk for stroke, blood thinners are used to reduce your risk. 1. Blood clot can form during atrial fibrillation 2. Blood clot travels 3. Clot blocks an artery in in the bloodstream the brain, causing stroke SPOT A STROKE F A S T FACE ARM SPEECH TIME DROOPING WEAKNESS DIFFICULTY TO CALL 911 7 For more information, go to www.nhrmc.org/stroke AFIB Patient Guide-REV-PRINT.indd 7 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Treatment Strategies Treatment Strategies Overview There are several treatment options for Afib. You and your doctor will work together on a treatment plan. ü Cardioversion The goals of treatment for Afib are to: ü Catheter Ablation for Afib • Prevent stroke AV Nodal Ablation • Control heart rate ü • Return the heartbeat to a normal rhythm if being in ü Medication a normal rhythm makes you feel better or is needed to control your heart rates ü Lifestyle Changes • Reduce any triggers for Afib Cardioversion If you go into Afib, your doctor may suggest a procedure called cardioversion as a treatment option. The cardioversion procedure involves an electrical current, or shock, to the heart muscle to restore the normal rhythm. It is a same-day procedure that takes minutes. Large patches (electrodes) will be placed on your chest and back. You will then be given sedation through an IV line to make sure you are comfortable. A timed electrical shock will pass through these electrodes to return your heart rhythm to normal. 8 AFIB Patient Guide-REV-PRINT.indd 8 5/31/19 2:54 PM Taking Control of Atrial Fibrillation Catheter Ablation for Afib Catheter ablation is a procedure that can be used to lessen triggers for Afib. The goal of this procedure is to reduce how often your Afib episodes happen as well as to decrease your Afib symptoms.