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Unformatted text preview: Running head: ATRIAL FIBRILLATION 1 Atrial Fibrillation Student’s Name Institution Date Atrial Fibrillation Introduction Often referred to as AF or AFib, atrial fibrillation is known to be the most common cause of a heart rhythm that is irregular. The condition that ensues in the event the heart tends to beat of rhythm is called heart arrhythmia. Usually, the heart's normal function is reliant on a regular pattern of blood flow that occasioned by its chambers' electric models. When someone is diagnosed with AF, the transmission described above does not transpire in an organised manner. ATRIAL FIBRILLATION 2 The results, therefore, are irregular contractions by the upper chambers of the heart (atria). In a nutshell, the condition of atrial fibrillation occurs when there is an irregular beating of the heartthis can mean either too fast or slowly (Schnabel et al., 2014). The occurrence of atrial fibrillation, according to research, can happen in brief and periodic episodes or on a permanent basis. According to the statistics of a study undertaken in 2015, 33.5 million persons suffer the condition of atrial fibrillation world over, accounting for a population percentage of about 0.5. Research attributed to Cleveland Clinic puts the number of Americans diagnosed with the disease at three million (Schnabel et al., 2014). However, scholars and pundits in the medical field have projected that the figure is bound to rise steadily to eight million by the year 2050. That, they submit, is and will continue to be influenced by the unhealthy conventional lifestyles that have placed a significant number of people at risk. Another factor that is reported to affect the situation is an increase in the ageing population of the United States. Other findings on the same topic have established that more women experience atrial fibrillation than their male counterparts. That, as submitted by the research, is grounded on the fact that AFib prevalence increases with an increase in age and the fact that the feminine gender has a longer lifespan. One of the latest studies into the disease has realised an interesting outcome that is African Americans exhibiting less likelihood of contacting AFib than their Caucasian counterparts. The management of atrial fibrillation attracts serious cost implications owing to the expensive options available for managing the disease. An estimated figure of at least 750,000 cases of admission related to atrial fibrillation occurs annually within the boundaries of the United States. On the flip side of the coin, a grim picture is painted of the same as it is reported that approximately 130,000 individuals lose the battle to the condition yearly. For more than two ATRIAL FIBRILLATION 3 decades now, the trend of death rate primarily caused by atrial fibrillation has been on the rise (Schnabel et al., 2014). The government of the United States spends around six billion dollars on an annual basis in managing AFib. On average, the medical expenditure for persons suffering the condition is about nine thousand dollars higher than those without the disease. Pathophysiology and Mechanisms Ischemic, valvar, hypertensive together with other forms of structural heart defects underlie some of the most prevalent and permanent cases of atrial fibrillation. Lone AFib only accounts for 15 percent of atrial fibrillation diagnoses. Although presently regarded as rare, the familial atrial fibrillation has been described in detail. An area on the chromosome was initially identified to contain the genome that is responsible for the causing of atrial fibrillation in families whereby the arrhythmia partitioned itself as a dominant character. However, research has established that atrial fibrillation could be a heterogeneous ailment (January et al., 2014). Therefore, atrial fibrillation pathogenesis is believed to emanate from an interaction of precipitating triggers that assume the form of ectopic foci that are rapidly firing and are located in a single or multiple pulmonary veins and an atrial tissue substrate that is abnormal yet capable of maintaining arrhythmia. While structural heart illness forms the basis for atrial fibrillation, common heart pathogenesis is yet to be well comprehended. Researchers submit that despite the fact that there exists a considerable overlap, triggers of pulmonary vein are perceived to play a more dominant role in younger patients with short AF paroxysms and healthy hearts, while an atrial tissue that is abnormal is bound to assume a significant role in cases of structural heart defects (Schnabel et al., 2014) and periodic or permanent atrial fibrillation. There exit several risk factors to the condition. The following are some of the most common predisposing elements to atrial fibrillation. ATRIAL FIBRILLATION 4 Hypertension The coronary heart disease or heart failure Pericarditis or rheumatic heart disease Obesity Hyperthyroidism Lung or kidney disorder Diabetes otherwise referred to as metabolic syndrome Sleep apnea Family history of AFib Behavior and lifestyle are also predisposing factors for atrial fibrillation. The likes of alcohol and caffeine abuse and elevated levels of stress and depression have the potential of influencing AFib. However, it is essential to take note of the fact that the exact cause of atrial fibrillation is often beyond determination. Obesity as a risk factor While there are many more predisposing factors to the cause of AF, one that has caught the attention of stakeholders is obesity. The condition of overweight is currently of significant concern as its prevalence has increased at a worrying trend. Presently, a third of adults across the United States are obese. Grounded on epidemiological statistics undertaken in some studies in numerous nations, there has been a definite establishment of the relationship therein obesity and atrial fibrillation. All these findings submit to the fact that obese patients are at a higher risk of having atrial fibrillation (January et al., 2014). Additionally, the overweight lot diagnosed with the condition often manifest the persistent form of AFib. ATRIAL FIBRILLATION 5 As established by Doctor Boyle, overweight patients more often than not exhibit cooccurring conditions responsible for the rise in the risks of developing atrial fibrillation. As mentioned above, these include hypertension, diabetes and hyperlimedia. Other research outcomes have established that pericardial fat and impaired diastolic function significantly influence risks of atrial fibrillation in obese patients. Research submits that the fat has a probability of being active metabolically in the secretion of cytokines and adipokines which are known to have pro-inflammatory and pro-fibrotic paracrine implications on the functioning of the heart (Schnabel et al., 2014). On the flip side of the coin, loss of weight relates to favourable structural and electrical remodelling heart alterations. Consequently, research has established that the condition, therefore, presents patients with better chances of maintaining a heart rhythm that is normal. Smoking and Atrial Fibrillation Research predicated upon the population of the United States indicated that individuals who smoke currently have double chances of atrial fibrillation development every 13 years. It, therefore, means that non-smokers have significantly lesser chances of being diagnosed with AFib. Additionally, according to HeartRhythm, a journal publication of the Heart Rhythm Society, persons that have quit smoking have a lower predisposing percentage to atrial fibrillation development as compared to active smokers. While the link between atrial fibrillation and other factors like obesity and hypertension is explicit, the relationship therein smoking and atrial fibrillation is yet to be as precise. An evaluation of a study conducted between 1987 and 1989 showed that 876 incidents of atrial fibrillation transpired between a 13-year period. Atrial fibrillation risk was determined to be 1.32 times more in former smokers and double the percentage of current smokers as compared to individuals who had never smoked before. ATRIAL FIBRILLATION 6 Additionally, former smokers with heavy usage showed 89 percent risk in AFib development while current heavy smokers manifested a higher risk trends of a percentage of 113 compared to individuals who never smoked. These results are a clear indication of the fact that renouncing the use of tobacco significantly reduces the chances of developing atrial fibrillation (Schnabel et al., 2014). The study found out that there was a 12 percent less risk of AFib development cases when compared to persons who continued to smoke. Accordingly, these findings are in support of what was previously determined in the indication of smoking is a risk factor for atrial fibrillation development. Despite the fact that overall, persons of black descent have a lower likelihood of developing atrial fibrillation, associations between AFib and use of tobacco do not indicate any differences in regards to race. Metabolic Syndrome and AF MS is regarded as a collection of cardiovascular or metabolic malfunctions perceived to have links with risks of developing an atherosclerotic cardiovascular illness. Some of the critical characters of MS include abdominal obesity, high blood pressure, dyslipidemia and glucose tolerance. The need for identification and management of MS-related issues has recently been highlighted by the prevalence of the condition among the United States population which currently stands at 20 percent (January et al., 2014). In the past, some individual elements that comprise MS have been linked to vulnerability to atrial fibrillation. A scientific report has advanced a viewpoint in support of the fact that susceptibility to atrial fibrillation is increased by metabolic syndrome. However, questions still linger as to whether increase incidences of atrial fibrillation risks in patients with metabolic syndrome may be a result of MS wholesomely or total risks of particular components. Be that as it may, the findings of the study, coupled with the prevalence of metabolic syndrome among the America's population, point out to MS health ATRIAL FIBRILLATION 7 vulnerability that has remained underappreciated. In the wake of these findings, it is, therefore, incumbent upon medical practitioners to underscore control of blood pressure, weight reduction and management of glucose intolerance in the prevention of atrial fibrillation. Effect of Exercise on AF Scholars have reiterated the critical role played by exercise in the management of atrial fibrillation. There are several exercise recommendations that include jogging, walking, hiking running and lifting of lightweights meant not to overwork the heart. Other options are viable for the keeping the condition under control. Research has established that regular physical activity if done well and with adherence to professional recommendations, has significant positive impacts on atrial fibrillation (Malmo, 2016). For instance, three months of exercise training increases capacity for physical activity and 6MWT alongside a considerable decrease in resting pulse rate in atrial fibrillation patients. Overall quality of life is bound to improve with a commitment to an exercise routine. While this is important in the quest to manage AFib, there existed effects that come with exercising with AF. While the most common symptom of AF is frequent tiring during exercise, the following are some of the symptoms that can make the physical activity tasking: Dizziness Sweating Heart palpitations Breath shortness and Anxiety One's heart is bound to race during physical activity. The results of racing heart are a drop in blood pressure which consequently leads to one feeling faint. In such a case, strenuous exercise ATRIAL FIBRILLATION 8 becomes harmful rather helpful. This information should come in handy for patients who wish to adopt an exercise regimen. Most of the time, exercising with AFib is a sure avenue to stronger life. Exercise is known to influence the maintenance of healthy body mass, which consequently prevents aggravation of heart failure (Ruff et al., 2014). Some physical activity benefits are especially positively influential if one is suffering from atrial fibrillation. These include lowering of hypertension and slowing of heart rate. One of the critical goals AF patients should have is a good life quality. Accordingly, exercise is the right remedy for stress and anxiety. Medication for AF As a treatment strategy, one of the primary goals of remedying the situation comes with prevention of formation of blood clots. In this case, the most common medication used include are warfarin and aspirin (Heidbuchel et al., 2015). Additionally, other drugs can normalise abnormal heart rates. They comprise of beta blockers, digitalis and calcium channel blockers. In the event the medications above are not able to provide a solution, there are other kinds of medicine engineered to maintain normalcy of a heart rhythm. The following medicines demand careful dosing and monitoring. Dofetilide (Cordarone) Amiodarone (Tikosyn) Flecanide (Tamboocor) Propafenone (Rythmol) Ibutilide (corvert) Sotalol (Sorine, betapace) ATRIAL FIBRILLATION 9 Procainamide (procan) There can also be a restoration of normal heart rhythm through the use of low energy shocks in a process referred to as electrical cardioversion. Further, if that again is not successful, then the physician may perform some procedure that uses radio wave energy in the elimination of abnormal tissues that hamper the heart's electrical signal. Another option lies in atrioventricular node ablation. Under this, some portion of tissue is destroyed by the use of radio wave frequencies. Upon the implementation of this procedure, the atria become incapacitated in sending electrical impulses. To ensure a normalised beating of the ventricles, the pacemaker comes in handy. For individuals who are already meant to undergo some heart surgery, the maze surgery then becomes the most probable option. To prevent chaotic electrical signals from getting through, small incisions are later made into the atria (Heidbuchel et al., 2015). On a general note, patient is advised to maintain a diet that is healthy for the heart that must include regular exercise. Outline and Justification of exercise program Conducted in Norway with a population sample of 51 patients with persistent AF who had were recommended to undergo ablation, a recent research was undertaken to establish an exercise program that is tailor-made for the improvement of atrial fibrillation. According to the lead researcher, Dr Sanjay Gupta, the study is not only a research about a revelation of efficient positive outcomes of exercise that offers a roadmap to be subscribed to by those suffering from ATRIAL FIBRILLATION 10 atrial fibrillation. The study that spanned 12 weeks had the following results that form the basis of the discussion under this subtopic. The atrial fibrillation meantime increased from 10 to 14 percent within the control population while simultaneously decreased from 8.1 to 4.8 percent in patients that enrolled in the exercise routine. There was a manifestation of significant improvement in regards to life quality of the group that took part in the program, consequently reporting a reduced frequency in episodes of AF as well as less severe AFib episodes. With a decrease in their weight out of the exercise, the sample group recorded reduced cholesterol levels. Eventually, there was an improvement of the left atrial function among the participants. As established by the study, the program was critical as it was able to lay bare the benefits that come with exercising for AF patients (Malmo, 2016). The following is the exact program that was done and which is consequently recommended for other patients that would wish to follow suit. Running or walking on a treadmill thrice a week for 12 weeks. Each session began with a warm that took 10 minutes of up to 60-70 percent of maximum participants' heart rate. (calculation of maximum heart rate is done by subtraction of one's age from 220). The warm-up was then followed by 4-minute heart rates of between 85 and 95 percent maximum heart rates with an active recovery period of 3 minutes between each interval. Each session was concluded with a cooling down five minutes. Below is how an entire session looked like: 60-70 percent maximum heart rate for 10 minutes. ATRIAL FIBRILLATION 11 85-95percent percent maximum heart rate for 4 minutes. 60-70 percent maximum heart rate for 3 minutes. 85-95percent percent maximum heart rate for 4 minutes. 60-70 percent maximum heart rate for 3 minutes. 85-95percent percent maximum heart rate for 4 minutes. 60-70 percent maximum heart rate for 3 minutes. 85-95percent percent maximum heart rate for 4 minutes. 60-70 percent maximum heart rate for 3 minutes. 85-95percent percent maximum heart rate for 4 minutes. 60-70 percent maximum heart rate for 3 minutes. 5 minute is cooling down at the end of session. Total time of session: 43 MINUTES Screening and safeguarding While the need for exercising has been underscored in the quest for proper management of AF, screening is critical if one is to avoid unnecessary injuries and to determine t suitability of time and body readiness for the same. It is recommended that if one has not taken part in physical exercise for some time, that they do not start with high-impact and intense training. The intensity and length of workouts should increase on a gradual basis. ATRIAL FIBRILLATION 12 Importantly, patients with AF should try and avoid injury-prone activities like outdoor biking and skiing. That is grounded on the fact that majority of thinner medications that are used in the treatment of AFib precipitate a situation to where there is bound to be profuse bleeding in the event of injury (January et al., 2014). Additionally, in the event one may want to lift weights, they should consult their doctors in the determination of safe loads to lift as too much may result in straining of the heart. Conclusion In conclusion, the prevalence of AF in the contemporary society has come with a myriad of challenges ranging from health to finances. Equally, the ensuing trends of the predisposing factors to atrial fibrillation point to a worrying trend. As such, it is time stakeholders understood what is at stake and ran awareness campaigns in educating the citizenry on the elements like obesity and hypertension that are primarily linked to AFib. On the other hand, those already diagnosed with the condition should exercise strict adherence to the existent recommendations by physicians in making sure they control the adversities that precipitated upon them by atrial fibrillation. ATRIAL FIBRILLATION 13 References Heidbuchel, H., Verhamme, P., Alings, M., Antz, M., Diener, H. C., Hacke, W., ... & Advisors:. (2015). Updated European Heart Rhythm Association Practical Guide on the use of nonvitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. EP Europace, 17(10), 1467-1507. January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cleveland, J. C., Cigarroa, J. E., ... & Murray, K. T. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. Circulation, CIR-0000000000000041. Malmo, V., Nes, B. M., Amundsen, B. H., Tjonna, A. E., Stoylen, A., Rossvoll, O., ... & Loennechen, J. P. (2016). Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial. Circulation, CIRCULATIONAHA-115. Ruff, C. T., Giugliano, R. P., Braunwald, E., Hoffman, E. B., Deenadayalu, N., Ezekowitz, M. D., ... & Yamashita, T. (2014). Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. T...
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  • Summer '17
  • ochuodho
  • heart rate, Atrial fibrillation, AFIB, familial atrial fibrillation

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