Atrial Fibrillation

This is a common abnormality of the heart rhythm and occurs with increasing frequency with age. It is due to the normal synchronized beating of the heart becoming disorganized. The pacemaker can no longer run the heartbeat as a faster chaotic beat takes over. This can lead to palpatations, breathlessness, chest pain and rarely blackouts. In addition, the chaotic rhythm can lead to a risk of blood clots in the heart, leading on to a risk of stroke. For this reason, treatment of AF is directed firstly at reducing stroke risk, and secondly at treating the symptoms by controlling the heart rhythm.

The AF is initially suspected by feeling your pulse. The diagnosis needs confirmation with an electrocardiogram (ECG). Often blood tests will be taken to look for possible causes of AF, and an echocardiogram (TTE) will be needed to ensure you do not have a structural heart problem. A 24-hour ECG monitor may be needed to see how fast you are going at other times.

The cardiologist will prescribe either aspirin or warferin to reduce the stroke risk. (see below) In addition, he may give you drugs to slow the heart rate down, such as betablockers or digoxin. He may suggest trying to get the heart beat regular again- Cardioversion. This can be done with drugs or with the application of an electrical treatment whilst you are sedated.

Choosing aspirin or warferin in atrial fibrillation (AF)- NICE guidelines

We can advise on whether you need warferin therapy based on the best available evidence. For example, if your CHADS2 score is 2 or more, warfarin is usually the best option to reduce the risk of stroke.