Chis Perzanowski MD
Palpitations, and elevated heart rate are symptoms that nearly everyone experiences at some point in their life. Most often, “skipped beats” or the perceived irregularity in cardiac rhythm is benign and may be the result of stress, poor sleep patterns or even increased consumption of dietary stimulatants (e.g. Caffeinated beverages, alcohol even in modest amounts). With increased age however, this may also represent a potentially very serious rhythm disorder known as atrial fibrillation.
“AFib” is the most common arrhythmia worldwide and it’s incidence is rapidly increasing due to an aging population [1]. It is a leading cause of disabling stroke, which sadly may be a presenting symptom for some patients [2]. For many people, AFib is identified during a routine medical visit without experiencing symptoms at all. However, it is not uncommon for AFib patients to suffer episodes of sudden unexplained tachycardia (heart racing). This disturbing symptom may be accompanied by shortness of breath or chest discomfort.
An EKG (electrocardiogram) taken at a medical office, walkin clinic or emergency room will readily record AFib during such an episodes. Risk factors such as hypertension, diabetes, sleep apnea have been shown to correlate with AFib. Now hear lies the difficulty with diagnosing AFib: when first appearing, it may be so in episodic fashion, so a “negative EKG” does not rule out this condition. Diagnosing AFib is vital to manage one’s risk for stroke. Often times, medicines such as “blood thinners” (anticoagulants) are prescribed in addition to drugs dedicated to controlling AFib [3]. Most primary providers will ask for a cardiology consultation to help determine the next best step.
References:
1. Global epidemiology of atrial fibrillation. Rahman F, Kwan GF, Benjamin EJ. Nat Rev Cardiol.
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2. The global burden of atrial fibrillation and stroke: a systematic review of the epidemiology of atrial fibrillation in regions outside North America and Europe.
Lip GY, Brechin CM, Lane DA.
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3. Variations in cause and management of atrial fibrillation in a prospective registry of 15,400 emergency department patients in 46 countries: the RELY Atrial Fibrillation Registry.
Oldgren J, Healey JS, Ezekowitz M, Commerford P, Avezum A, Pais P, Zhu J, Jansky P, Sigamani A, Morillo CA, Liu L, Damasceno A, Grinvalds A, Nakamya J, Reilly PA, Keltai K, Van Gelder IC, Yusufali AH, Watanabe E, Wallentin L, Connolly SJ, Yusuf S; RELY Atrial Fibrillation Registry Investigators. Circulation. 2014; 129:156876