Patient Recruitment And Organization
All patients who were hospitalized from January 1, 2009 to December 31, 2011 in the Division of Cardiology of the First Affiliated Hospital of Shantou University Medical College in Shantou, China, were recruited into our study. Patients who had the following conditions were excluded from the study: 1) previous surgery, or mechanical ventilation or other interventional procedures 2) community-acquired pneumonia 3) the presence of potential pneumonia symptoms such as fever, pulmonary shadows, and white blood cell abnormalities at admission 4) pacemaker implant recipients 5) sick sinus syndrome and 6) repeat hospitalization for any reason, in the selected period. The study was approved by the First Affiliated Hospital of Shantou University Medical College and complied with the local laws. This study did not need to write the informed consent because this was a retrospective analysis. The information from patient records was anonymized. All patient data were de-identified prior to analysis in order to ensure that the patients did not any undergo surgery including interventional therapy and radiofrequency ablation, mechanical ventilation or other interventional procedures during their stay at hospital.
Can Stress Trigger Afib
Another thing that can trigger episodes of atrial fibrillation is just stress by itself. Stress by itself, whether that is stress at home, or stress at work, can lead to episodes of atrial fibrillation. How does stress increase episodes of atrial fibrillation? First, when people are in periods of stress, they may also have these stress-related hormones released that can trigger episodes of atrial fibrillation. Also, the habits that people have when they’re stressed also can lead to episodes of atrial fibrillation. Those habits may include sleep deprivation. Perhaps you’re not sleeping as much when you’re stressed but other stress habits can include more caffeine intake because you’re tired or more alcohol intake because you’re stressed, and so all of those habits together can lead to episodes of atrial fibrillation.
Medicines To Reduce The Risk Of A Stroke
The way the heart beats in atrial fibrillation means that there is a risk of blood clots forming in the heart chambers. If these get into the bloodstream, they can cause a stroke .
Your doctor will assess your risk to minimise your chance of a stroke. They will consider your age and whether you have a history of any of the following:
You will be classed as having a high, moderate or low risk of a stroke and will be given medication according to your risk.
Depending on your level of risk, you may be prescribed warfarin.
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What Is A Normal Heartbeat
Your heart has four chambers. The right atria, left atria, right ventricle, and left ventricle. Your right atria receives deoxygenated venous blood from your body. Your left atria receives freshly oxygenated blood from your lungs. Both atria fill with blood while heart muscle is in a relaxed state.
- Sinoatrial Node. Its your normal pacemaker. Its in the right atria. Its also called the SA Node. This creates an electrical signal that causes both atria to contract. This causes blood from the right atria to enter the right ventricle, and blood from the left atria to enter the left ventricle. The electrical signal then travels to the ventricles. This causes the ventricles to contract. The right ventricle sends deoxygenated blood to your lungs. The left ventricle sends freshly oxygenated blood to all the cells of your body.
- Normal Sinus Rhythm . This is what its called when your normal pacemaker is at work. This is normal. Each beat is normal and orderly. Your heartbeats are equally paced apart. Your heart beat is regular. Your heart rate will be between 60 and 100.
Medicines To Control Atrial Fibrillation
Medicines called anti-arrhythmics can control atrial fibrillation by:
- restoring a normal heart rhythm
- controlling the rate at which the heart beats
The choice of anti-arrhythmic medicine depends on:
- the type of atrial fibrillation
- any other medical conditions you have
- side effects of the medicine chosen
- how well the atrial fibrillation responds.
Some people with atrial fibrillation may need more than one anti-arrhythmic medicine to control it.
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Why Does Atrial Fibrillation Happen And How Common Is It
Atrial fibrillation is the most common heart rhythm disturbance and affects up to 800,000 people in the UK.
The cause of atrial fibrillation is not fully understood, but it tends to occur in certain groups of people and may be triggered by certain situations, such as drinking excessive amounts of alcohol or smoking.
The condition can affect adults of any age or gender but:
- is more common the older you get
- affects about 10% of people over 75
- more common in men than women
Atrial fibrillation is more likely to occur in people with other conditions, such as:
- high blood pressure
Find out more abou the causes of atrial fibrillation and how it’s diagnosed
Fatigue And Sleep Deprivation Can Trigger Afib
Fatigue and sleep deprivation are common triggers for atrial fibrillation. When you are not sleeping well, there are a lot of stress hormones that get released. In addition you may be drinking more caffeine because you’re sleep-deprived, and all of this can lead to episodes of atrial fibrillation, so good sleeping habits are essential to minimize episodes of atrial fibrillation. Poor sleep can also be a sign of undiagnosed sleep apnea. See my previous blog post about how sleep apnea can affect atrial fibrillation.
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How Is Covid Affecting Atrial Fibrillation
Atrial Fibrillation is found in 19-21% cases of people suffering from covid-19. Around 36% of people who suffer from covid-19 have some kind of cardiovascular diseases out of which 42% of them having Atrial Fibrillation were not able to survive.
According to Covid-19 Task Force of Italian National Institute of Health 24.5% of people who could not survive covid-19 had Atrial Fibrillation.
These types of incidents are high in people who have a history or are suffering from pneumonia, acute respiratory distress syndrome and sepsis. The rate of developing or having Atrial Fibrillation is around 1/3 of the total people having these diseases.
This is just a statically analysed data which shows the prevalence of atrial fibrillation in covid patients. There are no specific reports which on the occurrence of AF during Covid-19 infection. The people who were fatal in these conditions were mostly older people above age of 70 years. Covid-19 takes 4-6 days to spread which is not adequate enough for Atrial Fibrillation to turn severe but any other cardiovascular problems and age factor can be a major cause of mortality.
Data Collection And Analyses
Diagnosis of thromboembolic/thrombotic events including pulmonary embolism, thromboembolic stroke, and transient ischemic attack was established in agreement with current guidelines . The diagnosis of thromboembolic stroke and transient ischemic attack of thromboembolic origin was verified by an experienced neurologist. Acquired data were independently reviewed and entered into the computer database by two blinded analysts. During ICU stay all recruited patients received standard prophylactic anticoagulation or therapeutic anticoagulation , if indicated, using low molecular weight heparin.
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Outcomes Of Atrial Fibrillation In Patients With Covid
- 1 Ming-yue Chen and Fang-ping Xiao have contributed equally to this workMing-yue Chen1 Ming-yue Chen and Fang-ping Xiao have contributed equally to this workAffiliations
- 1 Ming-yue Chen and Fang-ping Xiao have contributed equally to this workFang-ping Xiao1 Ming-yue Chen and Fang-ping Xiao have contributed equally to this workAffiliations
- Department of Geriatrics, Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- 1 Ming-yue Chen and Fang-ping Xiao have contributed equally to this work
- Preexisting AF was associated with increased mortality and ventilator use in COVID-19.
- New-onset AF during COVID-19 was significantly correlated with increased mortality.
- Patients with AF tend to present worse outcomes, which deserve managed appropriately.
What Is Atrial Fibrillation
Atrial fibrillation , also called Afib, is a condition which causes an irregular and often rapid heart rate, and can lead to stroke and heart failure.
It is one of a group of heart rhythm conditions called arrhythmias, which are caused by changes to the heart’s electrical impulses.
In a healthy heart, regular electrical signals keep your heart rate at a steady rhythm of between 60 and 100 beats per minute. This is called sinus rhythm. When you have AF, the electrical signals become random and chaotic, causing the top two chambers of your heart to twitch or quiver. This in turn causes your heart rate to become irregular and can cause it to beat faster than usual.
How common is atrial fibrillation?
If you’re living with atrial fibrillation, you’re not alone. AF is the most common type of heart arrhythmia.
A recent study estimated nearly one in 35 New Zealanders between the age of 35 and 74 have been diagnosed with AF – that’s more than 60,000 Kiwis. And it’s likely there are many more who don’t know they have it.
AF is more common as we age, peaking at more than 8% of Kiwis over the age of 85. On average Mori people are more affected and are diagnosed 10 years younger than non-Mori.
Types of atrial fibrillation
There are three different kinds of atrial fibrillation:
Atrial fibrillation is a progressive disease, so it is not uncommon for people with paroxysmal AF to develop persistent or permanent AF over time.
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How Does Afib Lead To Heart Failure
Heart failure means the heart isnt pumping enough blood to meet the body’s needs. AFib can lead to heart failure because the heart is beating so fast that it never properly fills up with blood to pump out to the body.
As a result, when the heart doesn’t efficiently pump the blood forward with strong contractions, symptoms develop because:
- Blood can back up” in the pulmonary veins which can cause fluid to back up into the lungs.
- When AFib causes heart failure, fluid in the lungs can cause fatigue and shortness of breath. Oxygen-rich blood is not being delivered to the body and brain, causing physical and mental fatigue and reduced stamina. Fluid also can build up in the feet, ankles, and legs, causing heart-failure related weight gain.
Treatment For Atrial Fibrillation
Our doctors use the least invasive approaches to treating AFib when possible. Depending on your symptoms and overall health, our doctors can offer you several options to treat your AFib. Our approach entails two key steps: managing your risk for stroke and restoring a normal heart rate and rhythm.
Step 1: Assessing and Managing Stroke Risk
At Stanford, every AFib care plan starts with a thorough evaluation of your risk for stroke, which is five times higher if you have atrial fibrillation. We assess and manage your stroke risk by using medications and advanced treatments including left atrial appendage closure. This procedure closes a small pouch in the heart where blood clots often form and can reduce your risk of stroke.
Step 2: Restoring Normal Heart Rhythm
AFib treatment at Stanford also focuses on restoring your normal heart rate and rhythm to alleviate common symptoms such as fatigue, shortness of breath and a racing heart. There are many options available to treat AFib. Whenever possible, we take the least invasive approach.
Medications
Your doctor may prescribe medications to slow your heart rate or to restore normal rhythm . Your doctors may tailor the medications such as anti-arrhythmic agents based on whether you have problems with your heart arteries, have impaired pumping function of the heart, or have kidney and liver abnormalities.
Lifestyle Changes
Treating related conditions
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Complications Due To Atrial Fibrillation
Stroke: Atrial Fibrillation causes chaotic rhythm which results to excessive blood pump in you upper chambers of the chest. This further forms clots and if these clots goes worse then there is a chance of dislodge from heart to the brain, which can cause a stroke. Mostly people who are older have higher risk of strokes than the youngsters. This also depends on the other medical conditions such as diabetes, high BP etc.
Heart Failure: If Atrial Fibrillation is not controlled at the right time then it can cause heart failure. In this condition your heart is unable to circulate enough blood to meet the demands of the body. Covid can also be a cause of heart failure.
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How Can I Improve Afib Naturally
If you are interested in natural treatment options for atrial fibrillation and are highly motivated in improving your symptoms naturally, to potentially reduce your need for medications or even procedures, then take a look at my online educational program, Take Control Over Atrial Fibrillation. Start off here to check out a free, no commitment, online workshop and see if this program is right for you. Thinking about lifestyle modifications is easy, but putting in place a system to keep you committed to achieve real results takes time and dedication, and with my help, and the support of other atrial fibrillation patients like yourself, we can achieve powerful and long-lasting results.
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How Is Covid Related To Atrial Fibrillation
Dr. Sunil Kumar, Cardiologist from Columbia Asia Hospital, Bengaluru tells about the relation between Corona virus and atrial fibrillation. He says although respiratory tract is most infected by covid, it is also seen evidently that Atrial Fibrillation was present in many cases that were infected with covid or had a history of cardiovascular diseases. Atrial Fibrillation is prevalent in arrhythmia which involves electrical, calcium and structural remodelling. The underlying cause of it is still not very evident but there have been significant cases which show indirect relation of Atrial Fibrillation with covid.
He says in most cases the heart rate goes from 100-175 beats a minute whereas the normal range is 60-100 beats a minute. In case of Atrial Fibrillation the signals which the upper chambers send to heart are chaotic which result in AV node. It is a connection between the atria and the ventricles which gets bombarded with impulses trying to get through the ventricles. This results in panic like situation and discomfort in normal heart rate and breathing which is also connected to Covid.
Can Afib Go Away On Its Own
Episodes of atrial fibrillation may come and go and resolve on their own in the earlier stages of atrial fibrillation. However, the long-term condition of atrial fibrillation is unlikely to correct itself if nothing is done. Atrial Fibrillation can be improved dramatically through a variety of methods including medications, procedures, and lifestyle modifications. Read more about common AFib treatments and success rate here.
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Can Arrhythmia Cause Lung Problems
So-called benign arrhythmias, such as atrial fibrillation, frequent ventricular premature contractions, and atrial flutter, are anything but harmless. In patients whose heart and lung function is already impaired by severe airway obstruction, these rhythm disorders can rapidly progress to a fatal cardiac arrest.
And Finally Are There Things You Can Do To Avoid Atrial Fibrillation
The best way to avoid developing AFib is to lead a healthy lifestyle. This includes:
- Drinking little or no alcohol
- Exercising daily
- Maintaining a healthy weight
February is American Heart Month, a great time to learn more about your heart health. Learn more about the cardiology services we offer at Bon Secours.
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What Is The Outlook With Atrial Fibrillation
Atrial fibrillation is generally not life threatening, many people live normal healthy lives with this condition, but it can be uncomfortable and often needs treatment.
This condition increases your risk by about four to five times of having a transient ischaemic attack or stroke.
This is because when the atria in the heart do not contract properly there is a risk of blood clot formation. Clots from the atria may break off and go to other parts of the body. A blood clot passing up to the arteries supplying the brain may cause a stroke.
For this reason, treatment may involve medication to control the heart rate or rhythm, and medication to prevent clots from forming in the blood.
Ask The Doctor: Racing Heart And Pneumonia
Q. When someone has pneumonia, is it common for the heart rate to fluctuate wildly?
A. Any significant lung disease can increase the heart rate. The stress of being sick causes surges in adrenaline levels, which make the heart accelerate. Lower oxygen levels in the blood also make the heart beat faster. In addition, pneumonia can push the heart into abnormal fast rhythms, such as atrial fibrillation or atrial tachycardia or flutter . These abnormalities may appear because higher pressures in the blood vessels of the lung cause the right side of the heart to dilate, which can throw off the heart’s electrical system.
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Atrial Fibrillation After Inhalational Lung Injury: A Troubling Complication Of A Rare Problem
Alejandro Perez-Verdia
1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
Abstract
Atrial fibrillation has been associated with lung diseases like pneumonia and chronic obstructive pulmonary disease but has only infrequently been associated with inhalational lung injury. We report two cases of resistant AF, which developed in young healthy manual laborers shortly after inhalational lung injury due to massive quantity of pesticides and anhydrous ammonia, respectively. They had no evidence of valvular or structural heart disease and did not have any previous medical problems. The AF was resistant to antiarrhythmic drugs and required pulmonary vein isolation in first patient and possibly the second patient who is currently being evaluated for this procedure. These arrhythmias may reflect direct myocardial injury during and after exposure. Alternatively, multiple mechanisms can cause atrial fibrillation in lung diseases, including hypoxemia, acidemia, inflammatory mediators, and structural changes in the atria and ventricle, and these could lead to AF in inhalational lung injury cases. AF needs to be excluded when patients present with palpitations after inhalational lung injury, especially since, if unrecognized, AF may lead to complications, like thromboembolic phenomenon and tachycardiomyopathy.
1. Introduction
2. Cases
3. Discussion
4. Conclusion
Conflict of Interests