In our last post, Dr. Langberg defined Atrial Fibrillation, or A-fib, as the quivering of the two upper chambers of the heart resulting from disorganized electrical activity, and the most common heart rhythm conditions requiring treatment. Together, Emory University Hospital and Emory University Hospital Midtown perform more than 3,600 electrophysiology procedures per year, including diagnosis and treatment procedures for A-fib. In this post, I’ll examine causes of A-fib and discuss how we diagnose it.
It’s crucial that we identify potential causes of A-fib in order to determine the best approach to treatment. Although we can’t always find the specific trigger, certain pre-existing heart and lung conditions are the most common causes. These conditions include:
- Thyroid conditions
- Obstructive sleep apnea
- Hypertension (high blood pressure)
- Coronary artery disease
- Heart valve disease
- Heart surgery
- Chronic lung disease
- Heart failure
- Cardiomyopathy (disease in which the heart muscle is weakened)
- Congenital heart disease
- Pulmonary embolism (blood clot to the lungs)
Less common causes of A-Fib include hyperthyroidism, pericarditis and viral infections.
In at least 10% of cases, we’re unable to find underlying heart disease or lung conditions. In these instances, A-fib may be related to alcohol, excessive caffeine use, stress, certain drugs, electrolyte or metabolic imbalances, or severe infections. It’s important to note that the risk of A-fib increases with age, particularly after age 60.
Next—how do we diagnose Atrial Fibrillation? There are a variety of methods, but our initial diagnosis begins with a conversation. We ask you about your medical history, including your health habits and symptoms, which may include fatigue, palpitations, chest discomfort, shortness of breath, or dizziness. We also ask about your family history, and then perform physical exams and conduct appropriate tests and procedures. One of the most useful tests is an electrocardiogram (EKG), a painless procedure that records the heart’s electrical activity. With an EKG, we can determine how fast your heart is beating, whether its rhythm is steady or irregular, how strong the electrical signals are when they pass through your heart, as well as how long it takes these signals to reach each section of your heart.
In our next Heart & Vascular post, we’ll explore treatment options for A-Fib at Emory, including innovative therapies and clinical trials.
For more information about the Emory Atrial Fibrillation Program, or to schedule an appointment, please call Emory HealthConnectionSM at 404-778-7777 or 1-800-75-EMORY.
Are you concerned that you may have A-fib? If you have questions or comments about A-fib diagnosis, please let me know in the comments section below.
About Michael Lloyd, MD:
Dr. Lloyd began practicing medicine at Emory in 2007—he specializes in Internal Medicine, Cardiology, and Cardiac Electrophysiology. His areas of clinical interest and research include arrhythmias, electrophysiology lab, and pacemaker. Dr. Lloyd’s organizational leadership memberships include the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society.