What is Atrial Fibrillation (A-Fib) | Dr. Robert Pilchik | Manhattan Cardiology

Atrial fibrillation (also referred to as AFib or AF) is a heart condition that causes irregular or quivering heartbeat, known as arrhythmia. The cause of AFib isn’t fully understood and can affect anyone, regardless of age. However, it’s more common with older people (65 and older) and often affects those with conditions like hypertension and atherosclerosis. It’s also more common in men than women and may be triggered by excessive smoking and drinking.

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Who Is At Risk of Having A-Fib? (0:12)
Common Symptoms (0:29)
Dr. Pilchik's Connection to A-Fib (0:45)
Diagnosis (1:21)
Treatment (2:06)

Atrial fibrillation is a irregular heart rhythm that puts people at risk of having stroke and also of developing congestive heart failure from rapid heart rates. Atrial fibrillation is generally associated with older age, high blood pressure, more common in diabetics and people with high cholesterol, but at other times, there are no underlying symptoms or reasons for a person to develop atrial fibrillation. Most people experience a rapid heartbeat, shortness of breath. On the other hand, there are certain people who have absolutely no idea that there are any atrial fibrillation. The other big symptom associated with atrial fibrillation is that they have a stroke.

Atrial fibrillation is a topic that's very near and dear to my heart. Not only have I treated thousands of patients with atrial fibrillation, but I myself have atrial fibrillation. I actually went and had a procedure performed at one of the major New York City hospitals to have my atrial fibrillation cured, where we go inside of a patient's heart with catheters, find where the abnormal electrical circuit is within the heart, and burn it out. That procedure works approximately 90% of the time, and it's a wonderful new advancement within the field of cardiology.

Atrial fibrillation is diagnosed primarily by doing an electrocardiogram. The electrocardiogram will show not only a rapid heart rate, anything above 100 beats per minute, but will also show an irregularity of the heart rhythm, which is really the hallmark of atrial fibrillation. After doing the electrocardiogram, we generally like to do an echocardiogram, which is an ultrasound of the heart, to see if there are any structural, functional, or anatomical reasons for a person to develop atrial fibrillation. Oftentimes, we'll also do a stress test to determine whether or not somebody has narrowings or blockages of the arteries of the heart that would also be a risk factor for developing atrial fibrillation.

There are three different ways to treat atrial fibrillation. The most common way to treat atrial fibrillation is with medication. We give a rate controlling medication that will keep the heart rate nice and slow, and then we'll give a blood thinning medication to prevent the blood from clotting so that the patient isn't at risk of having a stroke. The second way to treat atrial fibrillation is to do something called a cardioversion, where we bring the patient into the hospital, put them under general anesthesia, and then shock their heart back into a regular rhythm. The third way to treat atrial fibrillation is to do an ablation, where we go inside the patient's heart with catheters, find where the abnormal electrical circuit is within the heart, and then get rid of that either through freezing or burning the irregular heart tissue. Atrial fibrillation is a very common problem and a potentially lethal problem, but it is something that a cardiologist is well-prepared to not only diagnose, but to treat. If this is a concern for you, I recommend you book an appointment with your cardiologist.

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