Skip to main content

Atrial Flutter & AFIB Explained by Dr Gregory Bashian


 

Atrial fibrillation and atrial flutter are two similar cousin rhythm disorders. The approach to them can be similar in many ways, and many patients have both of them.

Thus, we will talk about them together. First, before the treatment of the a-fib or a-flutter, we typically perform tests to see if there are other causes or contributing factors. This may include blood work, an echocardiogram, a sleep study if we're looking for sleep apnea, etc.

Pin on Health is wealth
1. What is Atrial Flutter? Atrial flutter occurs when the electrical impulses form a circuit on top of the right atria (upper chambers of the heart), causing it to beat much rapidly than normally at approximately 300 beats per minute (bpm) instead of the normal 60-90 bpm. The impulses
https://www.pinterest.co.uk/pin/624452304591722630

In atrial fibrillation and atrial flutter, the top chambers of the heart, the atria, are beating very fast and basically quivering. This results in several issues, and we typically think of the treatment strategy as having three parallel approaches.

First, when the atrium is quivering, the blood doesn't move well. When blood lays still, it can form a clot, which can then leave the heart and go to the brain, and thus cause a stroke.

That is the most dangerous thing about this rhythm.

Thus, we look at each patient and we ask ourselves what that patient's risk of stroke is, and what we can do about it.

To decrease the risk of stroke, we typically use aspirin, true blood thinners, or sometimes even a procedure to block off the area of the heart where most stroke-causing clots come from. Not everyone needs true blood thinners.

We use blood thinners when the risk of stroke is higher than the risk of bleeding from the blood thinners. We measure a patient's stroke risk by asking several questions and giving the patient a point for each of the following.

Congestive heart failure, high blood pressure, age over 65, diabetes, vascular disease, and female gender. They get two points for age over 75 or for a prior stroke. If a patient scores one, we consider aspirin or true blood thinners.

Vascular Disease Treatment

If a patient's score is two or greater, we typically recommend true blood thinners. The second part of our approach to treating a-fib and a-flutter is controlling the rate of the bottom, main pumping chambers of the heart, the ventricles.

When the top chambers, the atria, are quivering so fast, they tend to drive the ventricles to pump very fast, as well. Thus, we often use medications that don't necessarily keep you in rhythm but do help slow your heart rate down.

Labels:

Comments

Post a Comment

Popular posts from this blog

A-FIB VERSUS JUNCTIONAL RHYTHMS

. ATRIAL FIBRILLATION: On your rhythm strip, the two most important characteristics are: . 1) A rhythm that’s IRREGULARLY irregular (meaning there’s no way to predict the next beat) 2) No discernible P waves . In fact, if you notice an irregularly irregular rhythm and you’re having to convince yourself that you see P waves... it’s probably A-fib (multifocal atrial arrhythmias like WAP/MAT could fit the differential) . *In my opinion: Don’t get caught up in using fibrillation waves as an absolute criteria. Very fine A-fib can sometimes produce a near isoelectric line between beats. . JUNCTIONAL RHYTHMS: The pacemaker cells surrounding the AV junction are capable of initiating regular impulses but at a slightly slower natural rate than their sinus and atrial superiors. The heart is built this way so that when the pacemaker cells with the fastest intrinsic rates are in action, those below are suppressed and function primarily to pass along the impulse from above. . For these reasons, we s...
1 comment
Read more

The Pathway of Blood

Here’s a great illustration on the pathway of blood flow through the heart. It may seem easy...but you should know this cold as well as the cardiac anatomy, both of which will make procedures and understanding hemodynamics easier. . . . 💙VENOUS BLOOD- Blood flows into the heart (into the right atrium) through two major veins (the superior and inferior vena cava) as well as from the coronary sinus (cardiac venous blood from the coronaries) and then out through the first AV valve (tricuspid valve) into the right ventricle. From there blood flows into the right ventricular outflow tract, across the first semilunar valve (pulmonic valve) and into the main and then left and right pulmonary arteries. Blood then enters the lungs to become oxygenated. . . . ❤️ARTERIAL BLOOD- now that blood is oxygenated flow goes from the lungs into the left atrium through 4 veins (usually) called the pulmonary veins. From the left atrium blood flows across the other AV valve (mitral valve) and into the left ...
Post a Comment
Read more

Cardiac Structures Visualized From Within The Heart

  Take a trip inside the heart ! . . . 🎦Here’s a great video of the cardiac structures visualized from within the heart. . . . The heart is composed of 4 major valves . . ♦️The AV valves: Mitral and Tricuspid . . 🔹The Semilunar Valves: Aortic and Pulmonic . . . 💞The aortic valve is made up of three major cusps: the right, left, and non coronary cusps. The pulmonic valve is made up of the right, left, and anterior cusps. The mitral valve has two leaflets: the anterior and posterior leaflets. The tricuspid valve has three leaflets: the anterior, posterior, and septal leaflets. The mitral and tricuspid Valves have subvalvular apparatuses with papillary muscles and chordae. . . . 📝Keys about the heart valves: . . 🔑 they are collagenous, non conductible tissue, that form the fibrous trigone of the heart . . 🔑 the tricuspid valve always names the morphological right ventricle and (for the most part) is always apically displaced . . 🔑 the mitral valve is the only AV valve that shar...
Post a Comment
Read more