Atrial fibrillation (AFib) is a type of supraventricular arrhythmia caused by issues with the electrical system of the heart. When the heart beats normally, it follows a consistent rhythm of 60 to 80 beats per minute, speeding up or slowing down only as a response to stress, emotions, or physical activity.

However, people with AFib experience an irregular, chaotic, and pretty fast heartbeat – as fast as 600 beats per minute. In this case, blood cannot flow properly into the ventricles, or lower chambers, of the heart. As a result, blood starts to pool, which then results in clots that can even lead to stroke, which can be life-threatening. Plus, AFib also limits blood supply throughout the entire body which can result in heart failure, which is again a serious condition.

Common atrial fibrillation symptoms include:

• Experiencing pain or fatigue after exercising
• Getting tired easily when exercising
• Heart palpitations (irregular or fast heartbeat)
• Racing or pounding feeling in the chest
• Excessive sweating
• Shortness of breath and difficulty breathing
• Chest pain or pressure
• Light headedness, dizziness, or fainting

How is Atrial Fibrillation Diagnosed and Monitored?

To get an atrial fibrillation diagnosis you should first visit an electrophysiologist who will perform a physical exam, check your heart rate and blood pressure, and go through your family health history. Then, you may be asked to do additional imaging tests, laboratory tests, and non invasive monitoring, if your doctor thinks they are needed to diagnose atrial fibrillation.

Here are the tests commonly used to diagnose and monitor atrial fibrillation:

Electrocardiogram (EKG)

The most important test for diagnosing AFib is electrocardiogram. It uses small and painless electrodes attached to the chest, wrist, and ankles. It is usually conducted when the patient is at rest, but it can also be performed when the patient is walking on a treadmill if the doctor needs to do an exercise stress test.

Imaging Tests

Various imaging tests can be used to treat or manage atrial fibrillation.

A common one is a transthoracic echocardiogram (TTE) which is an ultrasound of the patient’s heart to get detailed images of the heart’s size, shape, and motion while pumping blood. Furthermore, a TTE test can also help identify blood clots and help evaluate how well the heart can pump blood, called ejection fraction. And, as we mentioned blood clots can lead to a life-threatening stroke, while a low ejection fraction can point to heart failure.

A transesophageal echocardiogram (TEE) is yet another common imaging test that uses an ultrasound probe inserted through the mouth and into the esophagus, close to the heart. Being close to the heart, the probe can provide even clearer pictures compared to an EKG. Doctors typically use this test to rule out blood clots.

Moreover, advanced imaging like an MRI scan or a CT scan can also be used to look for or asses structural problems, injury, or scarring in the heart.

Surveillance Monitoring

When it comes to monitoring, a Holter device, an ambulatory telemetry device, or an implantable cardiac low recorder can be used, especially if the patient has unpredictable arrhythmia episodes.

A Holter device is a wearable device the size of a mobile phone. It records heart rhythm changes for one to two days. Then, the doctor checks the results and sees whether or not the patient has a heart rhythm disorder.

An ambulatory telemetry device is a portable heart monitor that can be worn for up to two weeks. It is used to measure the electrical activity of the heart and identify signs of a heart rhythm disorder.

Finally, an implantable cardiac loop recorder is also a small device, but it is inserted under the skin of the chest. It monitors and records the heart rhythm for up to two years without interruptions.