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Posted on Tuesday September 26, 2023 in Heart Health
Written by Dr Edward Leatham, Consultant Cardiologist
Atrial fibrillation (AF) is a common heart rhythm disorder that affects millions of individuals worldwide. In AF, the heart’s upper chambers (atria) experience chaotic electrical signals, causing them to quiver instead of contracting effectively. This can lead to a fast and irregular heartbeat, often referred to as palpitations. If left unmanaged, AF can increase the risk of stroke, heart failure, and other heart-related complications. However, with the right approach and self-monitoring, you can take charge of your heart health and effectively manage your AF.
Understanding Atrial Fibrillation
In atrial fibrillation, the atria contract rapidly at a staggering rate of 600 cycles per minute. The result is an irregular heartbeat with a pulse rate that can range from 100 to 180 beats per minute. This irregular rhythm can have adverse effects on the heart’s pumping efficiency and overall circulation.
The rate at which the heart’s lower chambers (ventricles) beat is crucial in managing AF. This is commonly referred to as the ventricular rate or pulse rate. The efficiency of the atrioventricular node (AV node), a key component of the heart’s electrical system, plays a significant role in determining the ventricular rate during AF. Medications are often used to enhance the AV node’s efficiency, helping to control the ventricular rate and manage the symptoms of AF.
Medication and Managing Ventricular Rate
Beta blockers, such as Nebivolol, Bisoprolol, Metoprolol, and Propranolol, are commonly prescribed to increase the efficiency of the AV node. By activating the AV node, these medications help to normalise the ventricular rate and reduce the palpitations associated with AF. Additionally, drugs like Verapamil, Diltiazem, and Digoxin are also used to achieve similar effects.
Challenges During Intercurrent Illnesses
During periods of intercurrent illnesses, such as infections or other stressors, the body’s response can impact the effectiveness of medications in controlling heart rate. Stress hormones released during illness can alter AV node function, potentially causing an increase in the heart’s rate. This increase in pulse rate can lead to complications, such as fluid accumulation in the lungs.
For individuals with long-standing atrial fibrillation, monitoring their pulse rate and even their electrocardiogram (ECG) during illness is essential. Detecting a sudden acceleration in heart rate can prompt timely action to address the issue and prevent complications.
Taking Control of Your Heart Health
To effectively manage AF during intercurrent illnesses, it’s important for individuals to be proactive in monitoring their heart rate. If you have long-standing atrial fibrillation, consider using tools like homecare ECG devices, which are readily available, to track your heart’s rhythm and rate. By doing so, you can detect any significant changes and take appropriate action.
In instances where the heart rate accelerates beyond the normal range, steps can be taken to address the issue. One potential approach is adjusting the dosage of beta blockers or other relevant medications. For instance, your doctor might recommend a slightly higher dose of medication during times of illness to help control the heart rate. This adjustment should always be done in consultation with a healthcare professional, as they can provide personalised recommendations based on your medical history and current condition.
Empowering Patients in Their Care
Empowering patients to actively engage in managing their heart health is a significant step towards better outcomes for those with atrial fibrillation. By monitoring your own heart rate and potentially even your ECG, you can take control of your condition and collaborate with your healthcare provider to make informed decisions about your treatment. This proactive approach can often prevent the need for hospitalisation and result in a more comfortable and healthier experience during intercurrent illnesses.
Conclusion
Living with atrial fibrillation requires a proactive and informed approach to managing your heart health. By understanding the role of the AV node and the importance of ventricular rate control, you can make informed decisions about your treatment. During intercurrent illnesses, monitoring your pulse rate and potentially using tools like homecare ECG devices can help you take timely action to prevent complications. Remember, you have the power to actively participate in your care and improve your quality of life while living with atrial fibrillation.
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