Good Example Of Research Paper On Atrial Fibrillation
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This paper will describe atrial fibrillation, its causes, diagnosis, and treatment. The paper will also focus on the clinical representation of the condition, the various types of it, and a conclusion part for the discussion.
Atrial fibrillation is a term used to refer to a condition of the heart that causes the rhythm of the heart to be abnormal (Patel, et. al., 2011). The heart is made up of four chambers, each with muscles that help pump the blood throughout the body in a regular co-ordinated rhythm, referred to as normal sinus rhythm. For the heart to perform its functions, its muscles contract and push the blood out of the heart, then they relax, to allow blood back into the heart. Every contraction and relaxation is what is called a heart beat (Patel, et. al., 2011). The atria are the right chambers of the heart, while the ventricles are the left chambers.
The atria collect blood and channel it through the ventricles, while the ventricles contract and push blood back into the atria, and into the body. The heart has its own natural pacemaker known as the sinoatrial node, which is located in the upper side of the right atrium, and it is responsible for the contractions of the heart. The sinoatrial node fires some electrical charges through both atria at regular intervals which cause a contraction, pushing blood into the ventricles (Patel, et. al., 2011). The electrical charges spread to the right lower atrium, where it delays the impulses. The heart then goes into a diastole, when all the blood gets back into the heart through the respective arteries. However, sometimes the sinoatrial may fire irregular electrical impulses, which in turn cause an irregular heartbeat, also known as arrhythmia.
What is Atrial Fibrillation?
According to Steg, et. al. (2012), atrial fibrillation is a condition of the heart that causes the heart to have irregular rhythm due to the irregular firing of impulses from the sinoatrial node. The node is usually overridden by other random electrical impulses in the atria. Fibrillation is a term used to refer to the partial contraction of the heart muscles that happens at a high speed, usually 400 times per minute (Steg, et. al.). Therefore, when the irregular discharge of impulses from the sinoatrial node occurs, it causes fibrillation. This implies that for a person with AF, it is difficult to predict the heart rate, or when a contraction and a relaxation of the heart muscles may occur, i.e., the heart rate is very irregular. Moreover, people suffering from AF have faster heart rates (140-180), although not always. Since the release of the electrical impulses is at a very high speed and irregular, the impulses randomly pass the ventricles, causing irregularity in diastoles and systoles. This irregularity also causes varying intensities of the contractions. According to Patel, et. al. (2011), atrial fibrillation affects more than 2.5 millions of Americans across all ages, gender, and races. Steg, et. al. (2012), indicates that AF, as one of the major forms of abnormal heart rhythm, is one of the major causes of stroke.
Causes of Atrial Fibrillation
Atrial fibrillation is a condition that affects people of all ages, gender, and race. Clinical and medical research hasn’t produced the causative agent of atrial fibrillation, although it is associated with some conditions that trigger it. It is estimated that more than 2.5 million Americans are affected by the condition.Studies have been carried out in the recent past, and they reveal that men are at a higher risk of acquiring the condition than women, regardless of any other interplaying factor. The chances of developing the condition increases with the older that a person becomes.
According to Patel, et. al. (2011), atrial fibrillation is more common among people with other heart problems, diabetes, high blood pressure, obesity, and any other medical complications. In addition, Patel, et. al. (2011) identifies AF as one of the major complications for people with other heart conditions like, pericardial disease, hypertrophic Cardiomyopathy, and dilated Cardiomyopathy. Additionally, Steg, et. al. (2012) named high blood pressure as one of the highest causes of atrial fibrillation, citing that it cased pressure on the arteries and heart muscles, which consequently leads to firing of irregular electrical impulses, and later, the development of AF. Lone AF is characterized by no other related factors and it occurs in every 1 out of 10 cases of atrial fibrillation
Clinical representation of atrial fibrillation ranges from the asymptomatic condition to the devastating cases of cerebrovascular accident. Most cases of atrial fibrillation are actually without symptoms. However, the most common symptoms that a person suffering from AF is likely to exhibit are headedness, dizziness, shortness of breath, fatigue, chest pain, and palpitation (Andrade, Khairy, Debrov & Nattel, 2014). These symptoms are mostly caused by the hemodynamic dysfunction of the heart which is brought about by the impaired blood flow, irregular contraction of the heart muscles, and the asynchronous atrial activity. In more serious cases, patients develop angina, dyspnea (Andrade, Khairy, Debrov & Nattel, 2014).
AF can be identified on the ECG monitor by lack of P-waves due to the uncoordinated atrial contractions, and by the irregular impulses displayed on the monitor due to the irregular heart rate. The rhythm and the rate of the heart are the best indicators, although it is sometimes difficult to determine an irregular rate if it is extremely fast. In such cases, the best clinical presentation would be achieved through the p-waves indication. Holter and event monitors are equipments that are used for measuring the electrical activity of the heart in an effort to diagnose arrhythmias or irregular beating of the heart (Andrade, Khairy, Debrov & Nattel, 2014). These monitors are used especially in the asymptomatic AF because they help detect the rate and the intensity of the heartbeat. The other was of diagnosing AF is the traditional simple ways of checking the pulse at the major points like the wrist or the neck, although this is not always conclusive (Andrade, Khairy, Debrov & Nattel, 2014)
Types of Atrial Fibrillation
There are three types of AF: Paroxysmal, Persistent, and Permanent AF. Paroxysm, meaning episodic, implies that the person experiences short episodes of AF, which clears in less than seven days on its own without medication. Paroxysmal AF occurs often and suddenly (Steg, et. al., 2012). However, some people may use medications as soon the paroxysmal AF sets on so as to clear the symptoms as quickly as possible. On the other hand, persistent AF lasts for a longer period and may not regress to normal without medications. Cardioversion treatments are used for persistent AF, but the condition can recur after some time (Steg, et. al., 2012). Permanent AF indicates that the condition is long-term and the heart rate hasn’t been reverted to normal. Patients with permanent AF use medications to control the rate, but not to bring back a normal rhythm.
There are various options for treatment that are available for AF, ranging from those that seek to control the rhythm, to those prevent stroke complications through blood coagulation. Rate control medications are used to bring the heart rate back down, which relieves the symptoms of headedness, dizziness, and fatigue. However, these medications do not control the irregular rhythm. Some of these medications include beta-blockers and calcium-channel blockers, among others (Narayan, Krummen, Shivkumar, Clopton, Rappel & Miller, 2012). Cardioversion is the synchronized conversion of an abnormal heart rhythm to a normal one using electricity of drugs. This method of treatment seeks to normalize the rhythm of the heart. AF ablation involves the insertion of a wire through the arm or leg into the heart, and using radio wave energy through that wire to restore abnormal electrical impulses. AF ablation is mostly used when medications and cardioversions do not work for the patient. Alternatively, patients can undergo the removal of the left atrial appendage. The left atrial appendage is responsible for production of thromboemboli, an enzyme that increases chance of embolic stroke in patients with atrial fibrillation (Steg, et. al., 2012).
In conclusion, this paper was an analysis of atrial fibrillation, clinical presentations, the causes and risk factors associated to the condition, and the available treatments for the condition. The paper also explored the different types of atrial fibrillation. Atrial fibrillation is a common heart condition which is characterized by irregular rhythm of the heart and a fast heartbeat. The condition can be diagnosed through various ways as discussed above, and it can also be treated in various ways, depending with the stage and severity of the condition
Andrade, J., Khairy, P., Dobrev, D., & Nattel, S. (2014). The Clinical Profile and
Pathophysiology of Atrial Fibrillation Relationships among Clinical Features,
Epidemiology, and Mechanisms. Circulation Research, 114(9), 1453-1468.
Narayan, S. M., Krummen, D. E., Shivkumar, K., Clopton, P., Rappel, W. J., & Miller, J. M.
(2012). Treatment of Atrial Fibrillation by the Ablation of Localized Sources. Journal
of the American College of Cardiology, 60(7), 628-636.
Patel, M. R., et al. (2011). Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation.
New England Journal of Medicine, 365(10), 883-891.
Steg, P. G., et. al. (2012). Symptoms, Functional Status and Quality of Life in Patients with
Controlled and Uncontrolled Atrial Fibrillation: Data from the RealiseAF Cross
Sectional International Registry. Heart, 98(3), 195-201.
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