Saint Alphonsus Heart Institute's Atrial Fibrillation Center is the most advanced heart rhythm program in the region, providing state-of-the-art services to Idaho and Eastern Oregon. From specially-trained cardiologists and surgeons to the most state-of-the-art technology, we work with you to correct your heart rhythm so you can get the most out of life.

What is AFib?

Atrial Fibrillation (AFib) is an irregular heartbeat due to electrical signals that contract the heart at random rates. AFib can often feel like palpitations, spasms, or rapid heartbeat. 

The heart works in tandem between the atria (upper heart chambers) and ventricles (the lower heart chambers), contracting and relaxing. But with AFib, both chambers are on an asynchronous pattern, beating at different intervals.

The irregularity begins at the atria, where it loses synchronization with the lower chambers. Chaotic and random signals are randomly circulating through the atria.

Now, the atria and ventricles are beating at inconsistent intervals, which leads to an irregular heartbeat. 

What Causes It?

First, we need to understand where the heartbeat originates. 

The heartbeat originates in what is called the sinus node. The sinus node is a group of cells in the upper left atria that work as the natural pacemaker of your heart. 

The sinus node will pass electrical signals that travel through the two upper heart chambers, and eventually to the atrioventricular node. The atrioventricular node is essentially a bridge between the upper and lower chambers of the heart. 

When an electrical signal travels to the atrioventricular node, the heart contracts, the contraction is the movement that pushes blood throughout the body.

With Afib, the signals in the upper chambers of your heart are chaotic. That means the signals are being passed through the atrioventricular node at different rates, making it quiver. 

So, why do these chaotic signals start in the first place?

AFib usually stems from medical issues or damage to the heart structure. Specifically, damage to the heart's electrical system. Harm can come from other heart issues, such as:

  • Heart disease
  • Heart attack
  • Stroke

Or it can be a product of health issues, such as:

  • High blood pressure
  • Obesity
  • Virus Infections
  • Overactive thyroid

It's important to note that AFib may not originate from one specific issue. It can be an accumulation of many things, such as stress and lack of sleep.

Symptoms

Symptoms for AFib can be discrete. That's why it's essential to have regular checkups with your physician. A physical examination can help prevent AFib issues from escalating. Some more common symptoms include: 

  • Racing heart
  • Irregular heartbeat
  • Chest pain
  • Shortness of breath
  • Weakness
  • Fatigue

Diagnosis

It's essential to seek regular physical exams to assess your medical history and potential symptoms. 

After reviewing any changes in your regular life, such as recent illnesses, medication or drug use, and stress levels, your physician may refer you to a cardiologist and run various physical examinations to help diagnose AFib correctly.

Below is a list of various examinations that can help diagnose AFib. 

Blood Test: A blood test cannot confirm AFib, although it can help identify any underlying issues that may lead to the problem. An initial blood test will help show a blood count, electrolyte panel, thyroid-stimulating hormones, and all other matters that may affect the structure of the heart.

Electrocardiogram (ECG or EKG): The electrocardiogram is a non-invasive monitor that reads your heart's electrical activity with electrodes, usually placed on your arms and chest area. The doctor's office is where the ECG will take place. 

Holter Monitor: The Holter monitor will monitor your heart's electrical activity for up to 48 hours. The longer-term measurement will increase the chances of finding any issues related to atrial fibrillation. Again, the Holter monitor uses small electrodes that help discreetly monitor your heart's electrical activity throughout the day.

Echocardiography: For further investigation, you may have to have an echocardiogram to help visualize the heart. The echocardiogram is an ultrasound of the heart to evaluate the structure, muscles, and valves. There are various versions of echocardiography, and stress echocardiography is standard for AFib diagnosis. 

Complications

AFib can significantly increase your risk of other heart-related issues, such as heart attack, stroke, and heart failure. 

Here are some complications that you need to be aware of:

Stroke and AFib: Stroke occurs when there is a lack of proper blood flow to certain parts of the brain. One of the most common reasons for reduced blood flow to the brain is blood clots. Blood clots have a higher chance of forming when AFib is occurring. Blood clots start within the atria because AFib makes it difficult for the heart to pump blood out of the heart properly. Blood may pool and cause a clot, which then circulates to other organs and cause Ischemia (blocked arteries).

Heart Failure and AFib: AFib overexerts your heart, but the heart isn't correctly pushing blood to the body. While your heart is working hard palpitating and quivering, it's not giving your body the oxygen it needs, which inevitably leads to failure.

Cardiomyopathy: An irregular heartbeat, beating too fast for too long, can cause the muscles in your heart to become weak. Irregular heartbeat is essentially the beginning of cardiomyopathy. Cardiomyopathy is a disease of the heart muscles that makes it very difficult for the heart to pump blood properly. As the condition gets worse, the muscles become weaker. 

Treatments

Not everyone with AFib is the same, that's why we offer a variety of treatment options. Working with you, your family, and our medical team, we will create a care plan that is unique to you and your situation.

RF (Radiofrequency) Ablation: RF is an ablation technique using heat to modify the heart tissue that is causing the heart to send harmful electrical signals.

Cryoablation: An ablation technique uses extreme cold to modify heart tissue that is causing the heart to send incorrect electrical signals.

Medication Management: Sometimes, atrial fibrillation symptoms can be managed through the use of prescription medication when appropriate.

Hybrid MAZE: A minimally invasive procedure in which a surgeon uses small incisions in specific places around the heart to isolate and redirect electrical signals that are causing irregular heartbeats. This procedure is highly successful for patients who have aggressive, long-standing atrial fibrillation. Saint Alphonsus is proud to be the only health system offering the Hybrid Maze procedure in Idaho and the surrounding area.

Benefits

  • Shorter hospital stay
  • Less pain, blood loss, and scarring
  • Reduction in risks of blood clots and stroke
  • In most cases, patients have few or no symptoms related to abnormal heart rhythms
  • A much higher cure rate for long-standing AFib compared to catheter-alone ablation
  • No splitting of the breast bone, resulting in a quicker recovery
  • Some patients can discontinue anti-arrhythmic drugs
  • Most patients are able to return to exercise and daily activities quickly
  • Persistent AFib for over a year
  • AFib uncontrolled by medication
  • AFib that is debilitating