ATRIAL FIBRILLATION
Atrial fibrillation, AF, is the most common heart problem seen in clinical practice today. This abnormal heart rhythm affects over 2 million Americans. AF results in a fast and irregular heart rhythm from 100–275 beats a minute. ( Normal heart rate beat is 60–100 bmp).
With advancing age, there has been a great increase of AF and strokes, with over 8% of Americans over 80 having this cardiac illness. It is the leading cause of deaths from heart failure and stroke.
Your heart has two upper chambers (atria) and two lower ones (ventricles). Abnormal rise in pressure is in the heart’s upper chambers,( the atria), results in loss of muscle mass in the atria making the muscle become fibrotic.
The upper right chamber contains a group of cells called the sinus node, which acts as your natural pacemaker and produces impulses that start your heart beat. In AF, the sinus node impulses are overwhelmed by rapid electrical discharges produced in the atria and the pulmonary veins, The lower chamber ventricles are overwhelmed and block the fragmented regular impulses that should generate your heart beat.
Since the upper chambers are not contracting in an organized manner, the blood does not move, and a clot forms. When the clot moves through smaller arteries it forms an embolus and plugs up one of the smaller arteries. Organ damage results because of the loss of oxygen and nutrients. 90% of these clots start in the left chamber. As the left atrium enlarges by AF, the door to the lower chamber ( the mitral valve) which normally acts like a sphincter, is stretched and the blood flow regurgitates. This quivering of the heart muscle in the upper chambers is triggered by high blood pressure, previous heart attacks, abnormal valves, common exposure to stimulants as caffeine, alcohol, and tobacco, and emotional or physical stress.
NSAIDs
A very common triggering cause of AF in the elderly is nonsteroidal anti-inflammatory medications NSAID), that are taken to minimize pain. Older people use a lots of NSAID and Cox-2 inhibitors (Celebrex, Vioxx). Those who filled a prescription for either in the previous two months had a 46% increase in AF risk. The risk increases 200 times in patients over 80, compared to those age 60. Current users of NSAIDs increase their risk of AF, stroke and heart attacks. by 17%, Those who use theCOX-2 inhbitors have been even higher relative risk of AF.
Chronic use of NSAID has been found as a major cause of AF, stroke and heart attacks. Common NSAIDs include: Aspirin, Celebrex, Voltaren, Lodine, Motrin or ibuprofen, Indocin, Orudis, Toradol, Relafen, Aleve or Naprosyn, Daypro, Feldene, Clinoril, and Tolectin.
The irregular heartbeat with AF, results in shortness of breath, difficulty swallowing, palpitations, anxiety, inability to exercise, chest pain, and sometimes angina. All of the above are related to an inefficient heart output caused by a rapid heart beat. With a decrease of oxygen, headaches and swelling of the feet are often present.
Treatments
The object of medical treatment is to control the heart rate to below 100 beats per minute and convert and maintain a normal heart rhythm. Conversion of an irregular heartbeat is done electrically or chemically. Electrically, a DC electrical shock is applied. Chemical conversion is done with drugs.
Vitamin K antagonists (VKA) reduces the risk of strokes but increases the risk of bleeding. Aspirin is contraindicated in AF, and does not prevent blood clots nor strokes to the brain in people with AF. Warfarin is the drug of choice and beneficial for all AF patients. Adding aspirin, greatly increases the risk of bleeding and is not indicated.
Acupuncture has also been proven to be very helpful in chronic AF. It restores electrolyte and electrical fields balance, reduces stress and anxiety, and lowers hypertension.
CAVEAT
Doctors today realize the dangers of NSAIDs and COX-2 in the elderly, and rarely recommend them because of the dangers of AF, stroke, and heart The attacks.
11.11.11
Sources: BMJ-British Medical Journal (2011, July 11). Common painkillers linked to irregular heart rhythm. ScienceDaily. Retrieved July 12, 2011, from http://www.sciencedaily.com /releases/2011/07/110705071747.htm