Classification of Atrial Fibrillation

Introduction:

Atrial fibrillation is an irregular heartbeat that begins in the atria, the heart's upper chambers. Among arrhythmias (irregular heartbeats), atrial fibrillation is one of the most prevalent. More than two crore people are thought to be affected by atrial fibrillation (AFib), making it a fairly common ailment. AFib is more frequent in men than women, and its prevalence rises with age. The conditions of hypertension, coronary artery disease, heart failure, and stroke are also linked to it.

What Is Atrial Fibrillation?

Atrial fibrillation is an example of arrhythmia or irregular heart rhythm. The atria, or top heart chambers, beat irregularly and separately from the lower chambers (the ventricles). As a result, the inadequate blood supply to the body may result from the heart beating with irregular rhythms, either rapidly or slowly. Atrial fibrillation may cause palpitations, shortness of breath, chest pain, and dizziness. In the elderly population, it frequently co-exists with other heart conditions or hypertension.

What Is the Classification of Atrial Fibrillation?

Atrial fibrillation is classified as acute and chronic type. But the recent classification of atrial fibrillation is divided into four types. They are as follows:

• Paroxysmal Atrial Fibrillation:

Paroxysmal Atrial fibrillation comes and goes. It starts and ends on its own. The duration of the irregular heartbeat can range from a few seconds to a week. However, most paroxysmal AFib episodes go away within twenty-four hours. Asymptomatic refers to the lack of obvious symptoms experienced by those with paroxysmal AFib. Managing asymptomatic paroxysmal atrial fibrillation may involve medication as a preventative step and lifestyle modifications, including cutting out caffeine and lowering stress.

• Persistent Atrial Fibrillation:

Persistent atrial fibrillation may or may not end on its own and lasts at least seven days. An acute, persistent AFib episode that requires the doctor to shock the heart into rhythm may require medical intervention, such as cardioversion. Preventive interventions, lifestyle modifications, and drugs may also be used.

• Long-standing Atrial Fibrillation:

Long-term persistent AFib continues for at least a year without a break. It frequently accompanies structural cardiac disease. The most difficult AFib to cure is this one. Ineffective heart rhythm or rate control medications are common. More invasive treatments might be required. These may consist of the following:

• Electrical cardioversion.

• Catheter ablation.

• Pacemaker implantation.

• Permanent Atrial Fibrillation:

When treatment fails to return the patient's heartbeat or rhythm to normal, long-term persistent AFib may become irreversible. The doctor chooses to discontinue all further treatment as a result. Unfortunately, this results in their hearts being permanently in an AFib state. Reliable research indicates that this type of AFib may lead to more severe symptoms, lower quality of life, and a higher risk of a serious cardiac event.

What Is the Duration of All Types of Atrial Fibrillation?

• Duration of Paroxysmal Atrial Fibrillation:

The duration of paroxysmal atrial fibrillation can vary greatly from person to person. Some episodes of paroxysmal atrial fibrillation may only last a few minutes, while others can last for several days or weeks. In general, episodes of paroxysmal atrial fibrillation that last longer than seven days are considered persistent atrial fibrillation.

• Duration of Persistent Atrial Fibrillation:

Persistent atrial fibrillation is a type of atrial fibrillation (AF) in which the abnormal heart rhythm lasts more than seven days. However, it can last weeks, months, or even years if not treated.

• Duration of Long-Standing Persistent Atrial Fibrillation:

The duration of long-standing persistent atrial fibrillation can vary greatly from person to person, with some experiencing it for months or years. In some cases, atrial fibrillation may become a chronic condition that persists for the person's lifetime.

• Duration of Permanent Atrial Fibrillation:

The duration of permanent atrial fibrillation, also known as chronic atrial fibrillation, can vary greatly among individuals. In some cases, the condition may persist for several years or even decades, while in others, it may be present for the individual's entire lifetime.

What Are Electro Cardioversion and Catheter Ablation?

• Electro Cardioversion:

Cardioversion is a medical procedure to treat certain abnormal heart rhythms (arrhythmias). Electrical cardioversion is a specific type of cardioversion that uses electrical energy to return the heart to its normal rhythm. The electrical energy is delivered to the heart through paddles or patches on the chest. The procedure is typically performed under sedation or general anesthesia and takes only a few minutes. The physician uses it to treat atrial fibrillation, atrial flutter, and other types of tachycardia.

• Catheter Ablation for Arrhythmias:

Atrial fibrillation (AFib) and supraventricular tachycardia are heart rhythm disorders that can be treated with catheter ablation. A slender, tiny tube called a catheter is inserted through a blood vessel in the arm or leg and up to the heart as part of the surgery. The catheter's tip is utilized to send energy, such as radiofrequency waves, to particular regions of the heart tissue after it has been inserted. This radiation leaves a tiny scar (ablation) on the cardiac tissue, altering the electrical conduction and preventing the arrhythmia-causing aberrant electrical signals. The procedure aims to stop or lessen the severity and frequency of irregular heartbeats. The surgery is typically performed in a daycare setting, and patients can leave on the same day.

What Is the Treatment for Different Types of Atrial Fibrillation?

The treatment options for atrial fibrillation are discussed below:

• Treatment for Paroxysmal Atrial Fibrillation:

  • Modifications in the way of life.

  • Beta-blockers, calcium channel blockers, and antiarrhythmic drugs help the heart return to normal rhythms or rates.

  • Anticoagulants to avoid blood clots if AFib flares up again.

• Treatment for Persistent Atrial Fibrillation:

  • Alterations in the way of life.

  • Beta-blockers, calcium channel blockers, antiarrhythmics, and anticoagulants to prevent blood clots are examples of drugs that can regulate heart rate and rhythm.

  • Electrical cardioversion.

  • Catheter ablation.

• Treatment for Long-standing Persistent Atrial Fibrillation:

  • Alterations in the way of life.

  • Beta-blockers, calcium channel blockers, antiarrhythmics, and anticoagulants to prevent blood clots are examples of drugs that can regulate heart rate and rhythm.

  • Electrical cardioversion.

  • Catheter ablation.

  • Electrical pacing (pacemaker).

• Treatment for Permanent Atrial Fibrillation:

  • Medication to improve heart function or prevent blood clots, such as beta-blockers and calcium channel blockers, but no treatment to return to normal heart rhythm.

Conclusion:

The atria, however, contract irregularly and more quickly than usual in a person with atrial fibrillation due to incorrect electrical signals. The atria then deviate from the ventricles. As a result, atrium blood accumulation increases the risk of blood clots and strokes. In addition, heart failure can result from atrial fibrillation, which speeds up the lower chambers' beating. Hence proper diagnosis and immediate management can help to relieve this condition.