Ask the Pharmacist
by Ron & Marla Chapleau

July 31, 2016


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Q) I went for my annual physical and discovered I have something called atrial fibrillation. What is that, and what do I need to know about it?

A) Atrial fibrillation (AF) is the most commonly diagnosed type of cardiac arrhythmia in Canada affecting about 350,000 Canadians currently.

In this condition, the heartís two upper chambers (the left and right atria) beat irregularly (and often very quickly), such that they fall out of coordination with the two lower chambers (the ventricles). The result is that the heart functions inefficiently which gives rise to an increase chance of suffering from a stroke, heart failure or some other cardiac abnormality.

Episodes of AF can come and go without a known trigger or remedy or they can continue indefinitely until hopefully treated. Although the condition itself is usually not life threatening, it is a serious medical condition that requires life-long monitoring, treatment and occasionally emergency intervention.

When the electrical signals that tell your various chambers to contract behave in an erratic manner, it results in these irregular heartbeats. This is usually due to damage to the heart itself from a variety of causes including high blood pressure, lung disorders, heart attacks, birth defects within the heart, sleep apnea, infections, exposure to toxins such as tobacco, alcohol and many other reasons.

Some people with AF have no symptoms and do not discover they have the disorder until they see a physician for an unrelated issue. Others suffer from symptoms such as a feeling that their heart is racing/ palpitating or skipping beats, increased feeling of fatigue or weakness, shortness of breath and a sensation of anxiety that leaves you shaky, dizzy and/or sweaty.

The goal of AF therapy is essentially two fold. The first goal is stroke prevention and the second is to relieve symptoms (if any) and improve the quality of life.

Stroke prevention is the mainstay as patients with AF have a five-fold higher risk of stroke relative to others of the same age and sex. As well, the severity of strokes in AF patients seem to be more debilitating than strokes from other causes as up to 3 in 5 become permanently disabled and 1 in 5 will die.

Stroke prevention is all about assessing the individualís risk of suffering a stroke which is based on a variety of factors. For those who have less than a 2% risk of suffering one in the next year, either no treatment or just a baby Aspirin may be all the treatment that is necessary. For the rest, blood thinner treatment should probably be initiated with the choice of drug once again coming down to multiple individual traits.

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The good news now is that many are no longer forced to take life-long warfarin therapy and the regular blood work and time that that entails. The newer agents seem to work at least as well as warfarin and require no more monitoring than most other drugs.

As far as reducing symptoms and improving quality of life, the focus is on controlling the heart rate, rhythm or both. There are a wide variety of agents that can be tried such as beta-blockers, calcium channel blockers, digoxin or antiarrhythmic drugs.

 In some cases, surgical procedures such as direct-current cardioversion or catheter ablation may be required. In summary, atrial fibrillation is a chronic condition.

Once youíve had an episode, you will have another at some point in time. The good news is that most people can feel completely normal and live a long, healthy and active life with the proper treatment and appropriate lifestyle modifications.


For more information about this or any other health related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Kincardine and Port Elgin..

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Sunday, July 31, 2016