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What is AFib?

AFib, short for atrial fibrillation and atrial flutter, are common arrhythmias where the upper portions of your heart (the atria) are not contracting in a rhythmic fashion with the lower chambers of your heart (the ventricles). This, in turn, leads to an irregular heartbeat, often without symptoms.

What are the symptoms of AFib?

Most patients do not experience symptoms with AFib, but if you do, you may feel your heart racing at rest (palpitations) and be experiencing a rapid ventricular response (RVR). Normal resting heart rates should be between 60-100 beats per minute, therefore, by definition, a rapid heart rate is greater than 100 beats per minute at rest. It is common for patients with AFib to have resting heart rates in the range of 120-169 beats per minute.

Other associated symptoms can be shortness of breath, fatigue and exercise intolerance. AFib can be intermittent (paroxysmal) where it comes and goes or chronic where the heart is continuously out of rhythm. One of the long-term consequences of poorly controlled AFib is the progression into a weakened heart condition known as congestive heart failure.

A normal heart rhythm compared to a heart rhythm with AFib.
Heart Rate Without AFib (left) VS Heart Rate With AFib (right)

What causes AFib?

Frequent causes of AFib include coronary artery disease, thyroid instability, electrolyte imbalance, sleep apnea and congestive heart failure. Often, the specific cause for the onset of AFib is unknown, but a full workup for a correctable cause is always warranted. A workup to identify potential reversible causes may include but is not limited to a stress test, echocardiogram, holter monitor, laboratory data or a left and right heart catheterization.

AFib Treatment

Many times, your cardiologist can control your heart rhythm with medications that are designed to slow your heart rate or return your heart rhythm to normal. If medications are unsuccessful, a cardioversion (DCCV) is sometimes used to restore your heart to normal rhythm. In this case, your cardiologist will deliver an electrical shock to your heart after you have been sedated.

You can also undergo an ablation for this rhythm. In this instance, you are taken into the cath lab and a small catheter is placed inside your heart to “burn” the atrial tissue often responsible for the abnormal rhythm. This procedure is invasive but is successful in approximately 90% of cases.

Finally, there is a new therapy for individuals who cannot tolerate long-term anticoagulation (blood thinners). A device called the Watchman device is inserted inside your heart to prevent the occurrences of stroke, often associated with AFib. This procedure is not for all patients but is reserved for select patients who are unable to tolerate long-term anticoagulation (blood thinners).

When should I see a doctor for AFib?

If you are experiencing symptoms consistent with AFib such as palpitations, shortness of breath or chest pain, it is best to contact your cardiologist or primary care physician for an evaluation. Because of your heart’s abnormal rhythm, small blood clots may form inside your heart and can travel through your blood stream into your head causing an acute stroke.

If you or someone you know is diagnosed with AFib, it is important to see a doctor to have your heart rhythm evaluated and treated, even if you do not have symptoms. To schedule an appointment with us, call (423) 926-4468 or fill out our contact form and one of our team members will contact you shortly.

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Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is an invasive heart procedure where an ultrasound probe is inserted into your esophagus (food pipe). A transesophageal echocardiogram allows your cardiologist to acquire detailed pictures pertaining to the structure, function and any valvular heart disease that many be present. This procedure demonstrates your cardiac function in much greater detail than a standard transthoracic echocardiogram.

Prior to your procedure, you should not have any food or drink for 8-12 hours. In most cases, you will be able to take your home medications as scheduled. Your cardiologist / healthcare provider will advise you if there are any requirements to alter your medication schedule. Prior to your transesophageal echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. During your procedure, you will be required to lie flat for approximately 30 minutes while the test is being completed. After your transesophageal echocardiogram, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home after the procedure. You can return to your normal activities the morning after your procedure.