Atrial Fibrillation: Causes, Symptoms, and Treatment Options

Q: Atrial Fibrillation: Causes, Symptoms, and Treatment Options

Hello, SPO users： Mitral valve prolapse is quite common, with an incidence of about 5%. <br>It often coexists with autonomic nervous system disorders and arrhythmias, which may lead some patients to experience symptoms such as chest tightness, shortness of breath, and palpitation

Arrhythmia

Hello.
I have been diagnosed with mitral valve prolapse for about five years, and recently I have noticed arrhythmias, sometimes with pauses and sometimes with extra beats.
During these episodes, I feel chest tightness, shortness of breath, and difficulty breathing.
After undergoing a 24-hour Holter monitor and an exercise stress test, the Holter monitor showed abnormalities, but the exercise stress test did not reveal any arrhythmias.
What could be the reason for this? Can I recover, or will I need to take medication for life? Additionally, can ulcers or gastroesophageal reflux cause these symptoms? I also heard that a type of ganglion blockade is effective for mitral valve prolapse; is that true? Thank you.

spo77, 30~39 year old female. Ask Date: 2004/09/03

Dr. Zhong Yuxun reply Cardiology

Hello, SPO users: Mitral valve prolapse is quite common, with an incidence of about 5%.
It often coexists with autonomic nervous system disorders and arrhythmias, which may lead some patients to experience symptoms such as chest tightness, shortness of breath, and palpitations.
If symptoms are frequent, pharmacological treatment may be indicated; however, some cases have minimal symptoms and do not require treatment.
Arrhythmias can be diagnosed using a 24-hour Holter monitor, as exercise stress tests typically do not reveal arrhythmias.
Peptic ulcers and gastroesophageal reflux can cause chest pain similar to that of mitral valve prolapse but do not lead to arrhythmias.
Ganglion blockade is reserved for the most severe cases of mitral valve prolapse that are resistant to medication and is rarely performed, requiring surgery.
Dr.
Chung Yu-Hsuan

Reply Date: 2004/09/03

More Info

Atrial fibrillation (AF) is a common type of arrhythmia characterized by an irregular and often rapid heart rate. It can lead to various symptoms and complications, including increased risk of stroke and heart failure. Understanding the causes, symptoms, and treatment options for AF is crucial for effective management, especially in patients with underlying conditions such as mitral valve prolapse (MVP), as you mentioned.

Causes of Atrial Fibrillation
AF can be triggered by various factors, including:
1. Heart Conditions: Conditions such as mitral valve prolapse, coronary artery disease, heart failure, and hypertension can predispose individuals to AF. In your case, the presence of MVP may contribute to the development of arrhythmias.

2. Other Medical Conditions: Hyperthyroidism, diabetes, and sleep apnea are known to increase the risk of AF.

3. Lifestyle Factors: Excessive alcohol consumption, caffeine intake, and smoking can also trigger episodes of AF.

4. Electrolyte Imbalances: Low levels of potassium or magnesium can affect heart rhythm.

5. Stress and Anxiety: Emotional stress or anxiety can lead to episodes of AF.

Symptoms of Atrial Fibrillation
Symptoms can vary widely among individuals. Common symptoms include:
- Palpitations (feeling of a racing or irregular heartbeat)
- Chest discomfort or tightness
- Shortness of breath
- Dizziness or lightheadedness
- Fatigue
In your case, the episodes of feeling like your heart is "stopping" or "skipping" beats, along with chest tightness and difficulty breathing, are consistent with AF symptoms.

Diagnosis
The diagnosis of AF is typically made through an electrocardiogram (ECG). A 24-hour Holter monitor can capture intermittent episodes of AF, while exercise stress tests may not always reveal arrhythmias if they occur at rest or under different conditions. The fact that your exercise ECG did not show abnormalities could suggest that your AF episodes are sporadic or triggered by specific factors not present during the test.

Treatment Options
1. Medications: Anticoagulants (blood thinners) are often prescribed to reduce the risk of stroke. Rate control medications (like beta-blockers or calcium channel blockers) can help manage heart rate. Rhythm control medications (antiarrhythmics) may also be used to restore normal rhythm.

2. Lifestyle Modifications: Reducing alcohol and caffeine intake, managing stress, and maintaining a healthy weight can help manage AF symptoms.

3. Procedures: In some cases, catheter ablation may be recommended. This procedure involves destroying small areas of heart tissue that are causing the abnormal electrical signals. There is also a procedure called "pulmonary vein isolation," which is effective for many patients with AF.

4. Surgical Options: For patients with structural heart issues, surgical interventions may be necessary. The "Maze procedure" is one surgical option that can help restore normal rhythm.

Addressing Your Concerns
Regarding your specific questions:
- Recovery: Many patients with AF can manage their condition effectively with medication and lifestyle changes. Some may experience periods of normal rhythm, while others may require ongoing treatment.

- Esophageal Reflux and Ulcers: Gastroesophageal reflux disease (GERD) can indeed cause symptoms that mimic or exacerbate AF symptoms, such as chest discomfort and shortness of breath. It’s essential to address any gastrointestinal issues you may have.

- Neurolysis for Mitral Valve Issues: There are emerging treatments involving neurolysis for patients with MVP and associated arrhythmias, but these are typically considered in specific cases and should be discussed with a cardiologist specializing in electrophysiology.

In conclusion, it is crucial to maintain regular follow-ups with your healthcare provider to monitor your condition and adjust treatment as necessary. If you experience worsening symptoms or new concerns, do not hesitate to seek medical attention.

Similar Q&A

Understanding Paroxysmal Atrial Fibrillation: Symptoms and Treatment Options

In May of this year, during a follow-up visit, I was diagnosed with arrhythmia, specifically paroxysmal atrial fibrillation and flutter. The doctor recommended proceeding with catheter ablation. After the follow-up in June, the treatment was adjusted to medication management. In ...

Dr. He Dongjin reply Cardiology
Hello, you have nearly 40% atrial fibrillation. The treatment options include medication management and catheter ablation. If you are still feeling very uncomfortable with medication alone, it is important to seriously consider undergoing catheter ablation. Regardless of the appr...

Understanding Atrial Fibrillation: Symptoms, Diagnosis, and Treatment Options

On December 21, 1992, at 10:00 AM, I experienced a heart rate of around 190 beats per minute, accompanied by cold sweats and dizziness, which lasted until I sought medical attention at 3:30 PM. My blood pressure was 127/97, and my heart rate was 194. I received an injection that ...

Dr. Zhong Yuxun reply Cardiology
Dear Jo, According to your letter, it appears to be paroxysmal tachycardia, most commonly paroxysmal supraventricular tachycardia (PSVT). The cause is typically an additional conduction pathway within the heart, leading to a reentrant circuit. This condition can be effectively t...

Managing Atrial Fibrillation: Ongoing Symptoms and Treatment Options

Hello, Doctor. About six years ago, I started a habit of jogging. Later, I noticed that my heart would race and beat irregularly after running. I went to a cardiologist and was diagnosed with atrial fibrillation. I underwent 3D mapping and ablation, but I have been on medication ...

Dr. Wu Xueming reply Cardiology
If your symptoms have recently worsened, it is recommended to go to the hospital for a 24-hour Holter monitor test to determine if there is a recurrence of atrial fibrillation.

Managing Atrial Fibrillation: A Comprehensive Guide for Patients

Hello, Doctor. I usually have a habit of running, but I overtrained before. After working shifts for a year, I started feeling a foreign body sensation in my right eye about six months in, which led to eyelid twitching. I used eye drops for a while and supplemented with fish oil,...

Dr. Chen Jili reply Cardiology
We recommend that you: 1. Discuss the above situation further with your attending physician, focusing on symptomatic treatment, or see if further examinations are necessary! Thank you, and wish you good health!