Types of Atrial fibrillation Disease with Causes & Nursing Intervention

Definition of Atrial Fibrillation Disease:

Atrial fibrillation disease is an abnormal heart rhythm characterized by rapid and irregular beating. In the normal heartbeat, the four chambers (Atria and Ventricles) of the heartbeat in a steady, rhythmic pattern.

During Atrial fibrillation, the upper two heart chambers (the Atria) beat rapidly, aimlessly, and irregularly out of coordination with the two lower chambers (the ventricles) of the heart.

A normal heart rate should be between 60 to 100 beats per minute with regular rate and rhythm. In Atrial fibrillation, the heart rate may be over 140 beats per minute.

Types of Atrial Fibrillation Disease:

There are three types of atrial fibrillation disease which are discussed below:

1. Paroxysmal Atrial Fibrillation Disease:

It comes and goes, and usually stops within 48 hours without any treatment. Symptoms can be mild or severe.

2. Persistent Atrial Fibrillation Disease:

Persistent Atrial fibrillation continues for more than a week. It may stop on its own or with treatment.

3. Permanent Atrial Fibrillation Disease:

Atrial fibrillation is present at all the time and normal heart rhythm may not be restored with treatment.

Causes of Atrial Fibrillation Disease:

There are different types of causes of atrial fibrillation, those are in the below:

1. High blood pressure,
2. Coronary artery disease,
3. Mitral stenosis / Regurgitation,
4. Cardiomyopathy,
5. Congenital heart disease,
6. Hypothyroidism,
7. COPD,
8. Obstructive sleep apnea,
9. Pericarditis,
10. Mitral valve prolapsed,
11. Heart failure,
12. Alcohol consumption,
13. Previous heart surgery,
14. Obesity,
15. Metabolic syndrome.

Sign and Symptoms of Atrial Fibrillation Disease:

Various sign and symptoms of atrial fibrillation disease are mentioned in the following:

1. Palpitations,
2. Shortness of breath during physical activity,
3. Irregular pulse,
4. Dizziness,
5. Lightheadedness,
6. Chest pain,
7. Fatigue,
8. Weakness,
9. Confusion,
10. Exercise intolerance,
11. Fainting (Syncope).

Diagnosis and Test for Atrial Fibrillation Disease:

Different diagnosis ways for atrial fibrillation are mentioned in the following:

1. Complete history and physical examination,
2. ECG,
3. Electrophysiology (EP) Study,
4. Exercise electrocardiogram and Trans-thoracic Echocardiogram,
5. Holter and event monitors,
6. Stress test,
7. Chest X-Ray,
8. Blood test (Thyroid study, S. Electrolytes, CBC, Prothrombin time, and INR).

Treatment for Atrial Fibrillation Disease:

Treatment for atrial fibrillation depends on symptoms, severity, and the presents of another heart disease. General treatment options include-

1. Medicine,
2. Some non-surgical and surgical cardiac Procedure that restore normal heart rate and
3. Lifestyle.

1. Medicine:

The aim of the treatment keeps well and leads a normal life; also prevent complications such as as- Stroke and heart failure. There are three main purposes of drug treatment:

a. Control heart rate,

b. Restoring normal heart rhythm,

c. Prevent blood clots and reduce the risk of stroke.

The main three types of drug treatment are discussed below:

a. Control heart rate:

Rate control medicine is used to slow heart rate, relieve symptoms, and keep heart rate 90-110 beats per minute. These medicines include:

• Beta-blockers (Metoprolol, Bisoprolol, Atenolol),
• Calcium Channel Blockers (Verapamil, Diltiazem),
• Digoxin,

b. Restoring normal heart rhythm:

Rhythm control medicine is also known as anti-arrhythmias. It helps return the heart to its normal rhythm and prevent further returning of Atrial fibrillation. Medicines used to control the heart rhythm include-

• Amiodarone,
• Sotalol,
• Flecainide,
• Propafenone,
• Dofetilide,
• Ibutilide.

c. Prevent blood clots:

Preventing blood clots is the most important part of treatment. In Atrial fibrillation, there is a high risk of blood clots forming in the heart chambers and if the blood clot travels to the brain through the bloodstream, the stroke must be happening. Anti-coagulant medicine includes-

• Warfarin,
• Aspirin,
• Newer anti-coagulants (Rivaroxaban, Dabigatran, Apixaban).

2. Nonsurgical and Surgical Procedures of Atrial Fibrillation:

a. Cardio-version:

A low-energy electrical shock is used to treat a factor irregular heartbeat and restore a normal heart rhythm. Before delivery shock, a moderate sedative must be used to temporary sleep.

b.Catheter Ablation: {Pulmonary vein isolation ablation (PVI ablation or PVA) and AV node ablation with pacemaker}

In this procedure, a wire is inserted through a vein in the leg or arm and sent radio wave energy through the wire to destroy abnormal tissue that may be hampering the normal flow of the electrical signal. Catheter ablation uses when medicines or cardio-version do not work.

c. Pacemaker filled:

Pacemakers help the heartbeat regularly.

d. Surgical Maze Procedures:

These procedures need open-heart surgery. It’s very rare and usually done when a person requires heart surgery for other reasons. For these procedures, a small portion of atria cuts or burns, and these cuts or burns prevent the spread of disorganized electrical signals.

3. Lifestyle:

The same healthy habits that protect against heart disease:

1. Eat a nutritious diet that includes fish,
2. Exercise regularly,
3. Control your blood pressure,
4. Avoid smoking.

A complication of Atrial Fibrillation Disease:

Complications of atrial fibrillation are below:

1. Stroke,
2. Heart failure.

Nursing Intervention for Atrial Fibrillation Disease:

Various nursing intervention for atrial fibrillation are mentioned in the following:

1. Monitor vital signs hourly, if the patient in the critical care unit.
2. Continue monitoring of ECG for any change.
3. Monitor heart sounds and apical pulse rate.
4. Give prescribed medications as ordered
5. Monitor side effects of various medications.
6. Closely monitor potential problems including hypotension, dizziness, and syncope.
7. Routinely monitor lab values such as APTT, PT, and INR for drug treatment of Heparin and Warfarin.
8. Routinely visit the physician and adjust the dose of Warfarin based on lab reports.
9. Observe for any abnormal bleeding.
10. Closely monitor signs of instability (Hypotension, Acutely altered mental status, signs of shock, Ischemic chest discomfort, and acute heart failure).
11. If instability present performed synchronized cardioversion as ordered by a physician.
12. Before the cardioversion, make sure the patient is sedated and the synchronized button is activated.
13. After the cardioversion, closely monitor for heart change to normal sinus rhythm and vital signs.
14. Monitor chest wall for burns and apply medication as ordered.
15. If catheter ablations are needed for treatment, monitor vital signs, heart sounds, and apical pulse.
16. If the maze procedure is part of treatment, the nurse should monitor vital signs, level of consciousness, and pain status.
17. Monitor the incision site for signs of infection.
18. Check the femoral catheter insertion site for bleeding and hematoma.
19. Adequate pressure must be maintained over the catheter site.
20. Check the foot of catheters such as capillary refill, pedal pulses, color, and movement for any complication.
21. Monitor intake output carefully and measure weight daily.
22. Assist patient with the activity of daily living as needed.
23. When the patient stable, provide essential health education about the side effect of Warfarin/ Heparin.
24. Provide education about the potential adverse effects of drugs and give importance to frequent medical checkups.
25. Check neurological status constantly.
26. Encourage the patient to talk about his feelings and concerns about his condition.
27. Encourage to give up alcohol consumption.
28. Inform the patient that take precautions before beginning any type of antibiotics or herbal medications and notify a physician.

More questions related to this topic:

1. Atrial Fibrillation and Heart Disease.
2. Atrial Fibrillation (AFib): Symptoms and Treatment.
3. Atrial fibrillation (AF) – Symptoms – Causes.
4. Is Atrial Fibrillation Considered a Heart Disease?
5. Heart disease – Atrial Fibrillation – Heart and Stroke.
6. Overview – Atrial Fibrillation.
7. Symptoms and Causes – Atrial Fibrillation.
8. What is the Fibrillation of the Heart?
9. What is Paroxysmal Atrial Fibrillation?
10. What is Atrial Fibrillation (AFib or AF)?
11. Atrial Fibrillation (AFib)
12. Atrial Fibrn Dillatioiabetes.
13. Atrial Fibrillation Heart Disease
14. Atrial Fibrillation Symptoms.
15. Treatment – Atrial Fibrillation.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”