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Irregular Heart Beat (Atrial Fibrillation)


Introduction

Helping the Heart

Treatments: Cardioversion


Introduction

Some people have an irregular or racing heartbeat – the medical term for this is atrial fibrillation or AF.  It can be caused by lots of different things and can usually be slowed down to a regular rate with tablets like B-blockers, calcium channel blockers or digoxin.

An irregular heartbeat means the heart doesn't pump the blood round the body as well as it should.  The blood can therefore become very slow when traveling inside the heart.  This slowing of the blood can cause little clots, which may then be pumped out into the blood circulation and travel to places such as the brain.  The clots can then block off the blood supply to one part of the brain, which causes a stroke.

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Helping the Heart

Medicines such as a B-blocker or some calcium channel blocker tablet (See the Medicines used for Stroke section) can help the heart to beat slower and better.

Sometimes Digoxin is added to one of these to help your pulse rate stay below 80 beats each minute.  Keeping your pulse below 80 beats per minute makes you feel much better.  There are also medicines such as warfarin that thin the blood and help to stop clots from developing.  Further information can be found in the Medicines used for Stroke section.

If you have atrial fibrillation then your pulse, when you are sitting down, should be less than 80 beats per minute (bpm).  If it's above 80 bpm, or if you feel breathless, then ask your doctor if you need more medicines.

If you have atrial fibrillation you should have had a discussion with your doctor about warfarin.  There are reasons why it may not be suitable for some people but make sure you have been asked your views and discussed whether or not you should be on it.

Everyone with atrial fibrillation should have an ECG to make sure the diagnosis is correct (as there are other causes of irregular heart beat).  You should then have an echocardiogram (an ultrasound scan of the heart).  This shows whether there are any problems with the valves in your heart, whether the walls of your heart have become thickened and how well your heart is pumping.  All of these can help to decide if there is something that can be done to get rid of the atrial fibrillation and what medicines you should take.

You will also have blood tests to see if your thyroid gland is working properly.  An overactive thyroid can cause atrial fibrillation and treating the thyroid problem can get the heart to beat regularly again.

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Treatments: Cardioversion

Some people with atrial fibrillation will be offered cardioversion.  This is done in hospital.  You will get a short electrical shock which often “jump starts” the heart back into a regular beating rhythm.  You would be put to sleep for this so it's painless, and the procedure would last about 10 minutes.  Most people go home within a few hours. Even when your heart starts to beat regularly again it is not a guarantee that it will stay that way so this treatment is not for everyone.

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