Atrial Fibrillation

WHAT YOU SHOULD KNOW:

Atrial fibrillation is a condition that causes the atria (top chambers of the heart) to shake or quiver. Normally, there is 1 contraction for every heartbeat. Atrial fibrillation causes more than 1 contraction for every heartbeat. Less blood is pushed into the lower chambers. The heart may not be able to fill with enough blood to provide good circulation with every heartbeat. Your atrial fibrillation may come and go, last for only a short time, or be a long-term condition.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Without treatment, your body may not get the oxygen it needs. You have an increased risk of a heart attack or heart failure. The shaking motion causes blood to pool. This pooling may allow blood clots to form. Clots may travel to your lungs or brain. This can be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Pulse oximeter:

A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

Intake and output:

Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

Oxygen:

You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

Rest:

You may need to rest in bed until your heart rhythm is under control. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver. Ask caregivers if you may exercise your legs in bed. Do this by lifting one leg off the bed and drawing big circles with your toes. Then do it with the other leg. Another good exercise is to lie on your side and pretend to pedal a bike. This may make your legs stronger and help circulation. Stop exercising if you become tired.

Medicines:

• Antiarrhythmias: These help slow your heartbeat and make it more normal.
  
  
• Beta blockers: These help keep your heartbeat in a regular rhythm.
  
  
• Calcium channel blockers: These help slow your heartbeat.
  
  
• Blood thinners: These help prevent blood clots. Clots can lead to stroke, heart attack, and death. Aspirin is a type of blood thinner. You may need to take an aspirin each day to help prevent blood clots. Do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take. If you are on other blood thinner medicine, ask your caregiver before you take aspirin for any reason.
  
  
• Electrolytes: You may be given electrolytes in the hospital if an electrolyte imbalance caused your atrial fibrillation.

Tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
  
  
• Transesophageal echocardiogram:
  
  
  • A transesophageal echocardiogram (TEE) is a type of ultrasound that shows pictures of the size and shape of your heart. It also looks at how your heart moves when it is beating. These pictures are seen on a TV-like screen. You may need a TEE if your heart does not show up very well in a regular echocardiogram. You may also need a TEE to check for certain problems such as blood clots or infection inside the heart.
    
    
  • You will be given medicine to relax you during a TEE. Caregivers put a tube in your mouth that is moved down into your esophagus (food pipe). The tube has a small ultrasound sensor on the end. Since your esophagus is right next to your heart, your caregiver can see your heart clearly.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.

Treatment:

• Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).
  
  
• Cardioversion: This is a procedure where an electric shock is given to your heart. The shock is usually given through paddles or sticky patches placed on your chest or back. The shock helps your heart return to a normal beat. Cardioversion may be needed if medicine does not make your heart work better. You may need a cardioversion if your heart rhythm is making you sick or is dangerous. You may be given medicine to help you relax before getting the electric shock. If the shock works, your heart rate and rhythm will return to normal. Medicine may be needed to keep your heart in a normal rhythm. You may need a cardioversion more than once.
  
  
• Cardiac ablation: Cardiac ablation is a procedure that uses heat energy to stop abnormal heart impulses. A wire is guided to your heart through an artery or a vein. Your caregiver finds the area of the heart that is causing the problems and applies heat energy to it. This may help your heart beat in a more regular rhythm.
  
  
• Pacemaker: This is a machine that helps your heart beat at a normal speed and in a regular rhythm. If your heart does not beat as it should, the pacemaker sends small electric signals to your heart. You may feel these signals.
  
  
  • Temporary: Large patches are placed on your chest and back. The patches are connected to a monitor. Your caregiver may need to put small wires through your skin and into your heart muscle instead. The wires are then connected to a small pacemaker box outside of your body.
    
    
  • Permanent: A permanent pacemaker is about the size of a wristwatch. It is implanted under the skin of your chest.
  
  
• Implanted cardioverter defibrillator:
  
  
  • An implanted cardioverter defibrillator is also called an ICD. It is a small device that monitors your heart rate and rhythm. If your ICD senses that your heart is beating in an unhealthy rhythm, it will give your heart a small electrical shock. This helps your heart start beating normally again.
    
    
  • An ICD is made up of a generator and leads (thin, flexible wires that attach to your heart). The generator and the leads will be placed inside you during a procedure. The generator has a metal shell with a battery and a small computer inside.
  
  
• Maze surgery: A surgeon makes many small incisions into the heart muscle. These incisions create a maze-like new path for the heart impulses to travel. This helps your heart beat in a more regular rhythm.

Learn more about Atrial Fibrillation (Inpatient Care)