Atrial Fibrillation

Q:  I was about to have some dental work done but had to delay it because my dentist told me my heart was fibrillating. I saw my doctor, who did an EKG which confirmed that I did have atrial fibrillation and recommended further testing and blood thinning medication.

I was feeling pretty good about my health until this happened. Is this a serious problem and if so, what can I expect?

A:  Your heart has four chambers. There are two receiving chambers for blood returning to the heart, called the left and right atrium. There are also two pumping chambers called the left and right ventricles. The atrium receives blood and also has a gentle and regular pumping ability that helps to fill the ventricle. Your heart also has a kind of internal wiring that begins in the atrium before going to the ventricle so that there is a sequence of the atrium pumping blood into the ventricle before the ventricle pumps blood to your lungs and the rest of your body.

In atrial fibrillation, the atrium contracts in a disorganized and inefficient way and can also affect the conduction of electrical impulses to the ventricle; this may cause your heart to beat too fast. Most people with atrial fibrillation notice an irregular heartbeat. Blood can sometimes form clots in the fibrillating atrium, which can be life threatening if they find their way into your blood vessels, causing strokes or damage to your lungs.

Usually a sound wave picture of the heart - called an echocardiogram - will be done to look at the way your heart beats and to identify the presence of a clot if one exists. Often you will be asked to take a blood-thinning drug called Coumadin or aspirin to reduce the likelihood of clot formation and the problems clots can cause.

It is possible to return your heart to its regular pattern of beating through medication and/or the passage of a small amount of electrical current across the chest wall. If that cannot be done, the blood-thinning medication will need to be continued, along with a drug to keep your heart rate at acceptable levels if it has the tendency to beat too fast.

Atrial fibrillation is a common heart problem that can be addressed if recognized and treated early. You should seek care from your doctor immediately if you are experiencing an irregular heartbeat and especially if you are short of breath. The possibilities of successful treatment diminish the longer you wait to seek treatment, so don’t delay.

Dr. Russell Robertson is Associate Dean for Faculty Affairs and Associate Professor of Family and Community Medicine at the Medical College of Wisconsin. His biweekly column of medical advice also appears in the CNI Community Newspapers throughout metropolitan Milwaukee.