Quick summary
If your parent has been diagnosed with atrial fibrillation (AF), he's not alone: According to the American Heart Association, 2.2 million Americans live with this heart rhythm abnormality.
Atrial fibrillation means that the atria (the upper chambers of the heart) are beating very rapidly and irregularly, "quivering" instead of contracting normally. In itself, AF isn't life threatening, but it can cause uncomfortable symptoms like palpitations, fatigue, dizziness, and nausea. It can also lead to other rhythm problems and congestive heart failure.
But the most serious complication is stroke: AF increases your parent's risk of having a stroke by fivefold because his quivering atria can't efficiently pump blood into his ventricles (the lower chambers of the heart). When leftover blood pools in one or both atria, blood clots may form and break loose from the heart.
AF isn't a cause for panic, nor is it a death sentence: Your parent can live a reasonably active life for many years. What you need to know is how your parent will be treated, what to do to help your parent prevent a stroke, and what warning signs you should look out for.
What is atrial fibrillation?
Atrial fibrilllation (AF) is a type of heart rhythm abnormality. The atria -- the upper chambers of the heart -- beat very rapidly and irregularly, "quivering" instead of contracting normally.
AF can cause uncomfortable symptoms like palpitations, fatigue, dizziness, and nausea. It can also lead to other heart rhythm problems and congestive heart failure. The most serious complication is stroke.
Will my parent need to take medications?
AF treatment is designed to help prevent a stroke and normalize heart rate and rhythm as much as possible. Your parent's doctor may prescribe a number of different medications:
To thin his blood and slow clotting , your parent should take aspirin (considered an antiplatelet drug) or warfarin (an anticoagulant). Warfarin is more effective against embolic strokes (caused by blood clots), but it also has more side effects. If your parent has an ulcer or other bleeding problems, his doctor will probably recommend aspirin instead.
The doctor will most likely prescribe medication to slow your parent's heart rate as well. Some of the most commonly prescribed drugs are beta blockers, calcium channel blockers, digoxin, and amiodarone.
Your parent's doctor may also prescribe medication to normalize his heart rhythm . One such drug, ibutilide, is given intravenously under close medical supervision. Other medications come in pill form.
When does more aggressive treatment make sense?
If your parent's AF doesn't respond to medication, the doctor may recommend a more aggressive approach. Even if your parent isn't at high risk for stroke, AF can have other complications. With prolonged AF, the atria may begin to enlarge. Enlarged atria pump blood even less efficiently, which can lead to congestive heart failure.
The doctor may recommend an electrical cardioversion to reset your parent's heart to a normal rhythm. This noninvasive procedure is performed in a hospital, and your parent will be given sedation through an IV. Once your parent falls asleep, two electrode pads or paddles will be applied to his skin: one near the breastbone, and the other on the lower left chest or back. A burst of electrical current is sent through the paddles, shocking the heart. If the procedure is successful, your parent's heart rhythm will be restored to normal -- at least temporarily -- and he'll probably be able to return home that day and resume normal activities in a day or two.
Radiofrequency catheter ablation is another procedure that may help. Your parent will be given a local anesthetic to numb the points where the catheter is inserted (usually the groin, neck, or elbow). The cardiologist will thread thin flexible tubes (catheters) through one or more blood vessels until they reach the heart. Once the cardiologist determines exactly which heart cells are causing the abnormal rhythm, she'll deliver a burst of radiofrequency energy to destroy those cells. Your parent should be able to go home that day and will probably be able to resume normal activities in a few days.
If your parent's AF occurs only when his heart rate is very slow, he may benefit from an implantable pacemaker to keep his heart beating at a normal rate. The procedure takes place in a hospital, with light sedation and local anesthetic. The cardiologist will implant the pacemaker wires directly into your parent's heart, while the battery and other components are inserted just under the skin of the chest or abdomen. The procedure takes about an hour, but your parent will spend the night in the hospital. His pacemaker will need to be checked in four to eight weeks.
In rare cases, the doctor might recommend an implantable atrial defibrillator. Like an electrical cardioversion, this device delivers an electrical shock to the heart to restore its rhythm to normal. Implantable defibrillators aren't typically used for AF, but it might be necessary if your parent also has a ventricular arrhythmia.
If other treatments fail to correct your parent's AF or if he has one or more strokes, he might require surgery. Unlike cardioversion or catheter ablation, surgery requires six to eight weeks of recovery. The surgeon may perform an operation called a maze procedure. (The name refers to the complex series of incisions required.) If your parent is undergoing surgery for another problem, the surgeon may perform a modified maze procedure instead. The Cleveland Clinic's website offers detailed descriptions of these surgical techniques.
How can I help my parent avoid a stroke?
Atrial fibrillation dramatically increases the risk of stroke. In fact, approximately 15 percent of strokes happen in people with AF. That's why it's vitally important that your parent do everything he can to reduce his risk.
Unless your parent has a serious bleeding problem, he needs to take either aspirin or warfarin to make his blood less likely to clot. But he also needs to make important lifestyle changes and control other medical conditions like high blood pressure, coronary artery disease, and diabetes.
For more detailed information about preventing stroke, see 10 Ways You Can Help Your Parents Prevent a Stroke.
What are the warning signs of stroke?
Because your parent's risk of stroke is so much higher with AF, you should familiarize yourself with the warning signs:
Sudden numbness or weakness of the face, arm, or leg -- especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden difficulty walking, loss of balance or coordination, dizziness
Although a sudden severe headache may occur in someone having a "red" stroke (in which bleeding occurs), it's not a symptom of a stroke caused by a blood clot.
For more information, see How to Tell if Your Parent Is Having a Stroke.
What should I do if I think my parent is having a stroke?
Call 911 at the first sign of stroke. Don't wait to see if the symptoms go away, and don't let your parent talk you out of calling.
Back to TopShould we worry about heart failure?
Prolonged AF can weaken the heart, ultimately resulting in congestive heart failure. But as long as your parent's AF is being treated, this is one complication you shouldn't worry about. And even if your parent does develop heart failure, he may still live well for many years.
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