Atrial Fibrillation?

Question

A friend of mine recently became very sick, and was told she had Atrial Fibrillation, she is only 30 years old. She went through a stress test and an echo and now has to wear a heart monitor for 30 days. What can the Atrial Fibrillation be caused from and do patients with Atrial Fibrillation usually have it for the rest of their lives?

Answer 1

Almost always, once afib, then always prone to afib and it may be a chronic on-going condition. The good news is that most people with afib do fine regardless. They may never be participating in Iron Man competitions, but are fine for day-to-day needs.

The difficulty in converting atrial fibrillation back to sinus rhythm is not dependent on age, rather is dependent on the source of the afib. If the left atria is dilated and large, it predictably will not go back to NSR and stay there very easily. Mentioning specific medications is not too useful here (there are at least four separate classes and a number of choices among them) because each patient is individual and often requires a unique treatment - and there are new agents being introduced.

Most recently, conventional wisdom has been to convert to NSR (normal sinus rhythm) if there is a reasonable chance of conversion and staying in NSR. If NSR was unlikely, then rate control (and chronic anticoagulation with Coumadin depending on patient age) has a the same likelihood of death as NSR and that then becomes the goal. In other words, a controlled rate is almost as good.

A recently published article showed however that QUALITY of life is significantly reduced if a patient remains in afib. Its early but this may mean there is more effort to convert to NSR in the future, possibly with more use of surgical intervention/pacemakers...time will tell.

The fact that your friend has a 30 day monitor means to me that the doctors are evaluating her current treatment to see if it is effective in keeping the heart rate either regular or at a regulated rate.

One common source of afib in young people is sleep apnea. If there is ANY possibility that sleep apnea may be at play(people who are overweight for instance) in this case, then your friend should go for a sleep study to have it evaluated. Its entirely treatable and can make a big difference in her long term cardiovascular, lung function, and day-to-day well being.

I hope this helps. Good luck.

Answer 2

No they dont...
Stress test (bruce protocol) has four stages, and the stress starts when the person has to "jog" in order to be in synchronyzed speed with the band, in the meantime, the waves of the heart are registered...thats what they mean by "stress"...(physical effort in order to amplify the waves registered in the monitor)
Most common causes of atrial fibrillation, are in young females: Hyperthyroidism (functional goiter, or accelerated thyroid, thyroiditis either viral or immune inflammation of the thyroid gland), more rarely, enlargement of the small cavities of the heart (atria) after a rheumatoid arthritis disease, (even if treated in early childhood), and congenital abnormalities in the valve that exist betweeen the atria and the ventricles (narrowing, due to scarring can lead to enlargement of the atria)..
As soon as the cause of the fibrillation is found, proper treatmen will cure the symptom ( jumping heart beats or exatrasystoles) by finding the porper cause, that is generally, found in almos all the cases...
The monitor, is set there to pass to a rolling tape, the heartbeats graphic for 24- 48 hours (Holter procedure) in order to analyze the results of the waves from the heart, however, if there is doubt, the cardiologist will set the time during he or she considers that there will be enough information gathered by the monitor (nowadays the information is long distance, via a small transmitter) so that the findings can be correlated with the echocardiogram:::
There is NOT such a thing as fibrillation for the rest of our lives......
There are some steps before making the definite diagnosis, and digitalis 0.25 mg PO per day, will benefit her, as a "time buyer", if the EKG is considered fit by the cardiologist...

Answer 3

This will help you understanding in summary:
Causes

Many conditions can cause disorganized electrical activity in the atria to develop. In many cases, a "leaky" or a sticky (stenotic) mitral valve can result in an enlarged (dilated) atria.

Patients with a history of high blood pressure (hypertension), can develop atrial fibrillation, because high blood pressure eventually begins to affect the atria.

Blockages in the arteries that supply the heart with blood (coronary arteries), heart attacks, and an overactive thyroid gland can also lead to atrial fibrillation.

Excessive consumption of alcohol acts as a toxin on the heart, and patients who binge drink or chronically drink large amounts of alcohol are at risk for developing atrial fibrillation.

Patients with heart failure, in which the left ventricle, the heart�s main pumping chamber, does not pump blood normally, may develop atrial fibrillation as blood "backs up" from the left ventricle into the left atrium.

Rarely, a blood clot develops in the legs and travels to the lungs, causing a pulmonary embolus that can trigger atrial fibrillation.

Pericarditis (inflammation of the tissue that surrounds the heart, the pericardium) can irritate the atria and lead to atrial fibrillation.

In some patients, there simply is no clear cause for the condition.
Atrial fibrillation describes an irregular and often rapid heart rhythm. The irregular rhythm, or arrhythmia, results from abnormal electrical impulses in the heart. The irregularity can be continuous, or it can come and go.

Normal heart contractions begin as an electrical impulse in the right atrium. This impulse comes from an area of the atrium called the sinoatrial (SA) or sinus node, the "natural pacemaker."

* As the impulse travels through the atrium, it produces a wave of muscle contractions. This causes the atria to contract.

* The impulse reaches the atrioventricular (AV) node in the muscle wall between the 2 ventricles. There, it pauses, giving blood from the atria time to enter the ventricles.

* The impulse then continues into the ventricles, causing ventricular contraction that pushes the blood out of the heart, completing a single heartbeat.

In a person with a normal heart rate and rhythm the heart beats 50-100 times per minute.

* If the heart beats more than 100 times per minute, the heart rate is considered fast (tachycardia).

* If the heart beats less than 50 times per minute, the heart rate is considered slow (bradycardia).

In atrial fibrillation, multiple impulses travel through the atria at the same time.

* Instead of a coordinated contraction, the atrial contractions are irregular, disorganized, chaotic, and very rapid. The atria may contract at a rate of 400-600 per minute.

* These irregular impulses reach the AV node in rapid succession, but not all of them make it past the AV node. Therefore, the ventricles beat slower, often at rates of 110-180 beats per minute in an irregular rhythm.

* The resulting rapid, irregular heartbeat causes an irregular pulse and sometimes a sensation of fluttering in the chest.

Atrial fibrillation can occur in several different patterns.

* Intermittent (paroxysmal): The heart develops atrial fibrillation and typically converts back again spontaneously to normal (sinus) rhythm. The episodes may last anywhere from seconds to days.

* Persistent: Atrial fibrillation occurs in episodes, but the arrhythmia does not convert back to sinus rhythm spontaneously. Medical treatment is required to end the episode.

* Permanent: The heart is always in atrial fibrillation. Conversion back to sinus rhythm either is not possible or is deemed not appropriate for medical reasons.

Atrial fibrillation, often called A Fib, is a very common heart rhythm disorder.

* It affects about 1% of the population, mostly people older than 50 years. This amounts to more than 2 million people.

* The risk of developing atrial fibrillation increases as we get older. About 5% of people older than 80 years have atrial fibrillation.

For many people, atrial fibrillation may cause symptoms but does no harm.

* Complications can arise, but appropriate treatment reduces these risks.

* If treated properly, atrial fibrillation rarely causes serious or life-threatening problems.

Answer 4

At 30 she should be easy to convert back into sinus rhythm. They can just put her on digoxin. She will be prone to it for the rest of her life, but it is easily controllable at a young age. If the echo was normal, no mitral prolapse, she is fine. If she has too many problems they will suggest ablation. My personal opinion is to avoid it as long as humanly possible. Try to control it with meds.
I have gone in and out of Afib since I was 11. I have 5 children and am now over 45 and just fine. She will be fine, I promise. As people get older-- sixty plus-- it is more difficult to keep them in a sinus rhythm. So they choose to give blood thinners and just try to control the speed of the Afib. Life is tougher for them, but they can still live a relatively good life, but just feel short of breath. At your friend's age of 30, she should do well and stay in a decent rhythm just on meds. Her life will only be mildly affected by this. It is scary, but it will be ok.
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and the previous poster left out node malformations as a cause of arrhythmias
Most heart rhythm disturbances in young people are not mechanical (valve issues, rheumatic fever or other issues he mentioned), or hormonal (thyroid) or even drug induced.... they are electrical caused by a node issue.

Answer 5

it can be caused by stress. I went through all the same test, and all was due to stress.

Answer 6

Look it up instead of asking here.