Margot Vloka, M.D.

Margot Vloka, M.D.

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Atrial fibrillation, or AFib, is a dangerous, chronic, progressive, multifactorial disease that leads to a shorter, less satisfactory and frequently disabling life. It is also the most commonly diagnosed heart arrhythmia, or irregular heartbeat, condition in the United States.

In a normal heartbeat, the four chambers of the heart work together to fill and empty blood from the upper chambers to the lower ones. In AFib cases, electrical signals that control the heart can misfire, causing too fast or too slow a heartbeat. As a result, blood pools in the heart chambers, leading to potential heart problems.

Atrial fibrillation is diagnosed when the particular arrhythmia associated with this disease is first found using an electrocardiogram, or ECG. It’s a test that measures the electrical activity of the heart. While 15% of patients with AFib won’t experience arrhythmia in their lifetime, the majority of patients will progress from occasional episodes to a regular or permanent stage of AFib.

What are the symptoms?

Although many patients have no symptoms while having an irregular heartbeat caused by atrial fibrillation, many patients experience tiredness, palpitations, difficulty breathing, hypotension and/or fainting. Even in those with no symptoms atrial fibrillation is a progressive disease that can lead to serious complications.

What are the consequences?

Patients with atrial fibrillation have two times higher death rate, three to five times higher chance of developing heart failure and five to seven times higher stroke rate, as well as increased rates of cognitive impairment/dementia and a lower quality of life when compared to those without atrial fibrillation.

Can we do anything about atrial fibrillation?

Yes. We know some of the risk factors for atrial fibrillation. Therefore, prevention is essential in the management of this disease.

Primary prevention is the management of the risk factors that can cause atrial fibrillation. For example, managing high blood pressure, coronary artery disease, heart failure, valvular heart disease, reduced physical activity, obesity, diabetes, hyperactive thyroid, sleep apnea, lung disease, smoking, excessive alcohol intake, and drug abuse can all positively impact overall health and reduce the chances of developing AFib.

Secondary prevention is the management of risk factors that can cause existing AFib to progress or worsen. The longer that a heart experiences irregular beating, it can lead to changes in the heart that in return cause further episodes of AFib and progression to a permanent form of arrhythmia. Therefore, antiarrhythmic medications and electrical cardioversion are used to restore the heart’s rhythm. In some instances, a minimally-invasive procedure might be necessary to stop or slow down the progression of the disease.

Many patients with atrial fibrillation require blood thinners to decrease the risk of a blood clot. Patients who cannot take blood thinners may benefit from a procedure that can help reduce the risk of blood clots and decrease the risk of stroke.

Since atrial fibrillation is a complex and chronic disease, its management requires a partnership among healthcare providers, patients and their families. This collaboration helps ensure that patients’ wants, needs and preferences are respected, and that patients have the education and support they need to make decisions and participate in their own care.

Dr. Margot Vloka, M.D., is a cardiac electrophysiologist at Saint Alphonsus Regional Medical Center in Boise, and the first female physician in the world to complete 1,000 robotic heart procedures using the Stereotaxis Robotic Magnetic Navigation System.

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