2. Atrial Fibrillation June 2012

3. Presentation Outline  All about Atrial Fibrillation  What is it?  Who is affected?  How does it affect you?  Stroke  Risk factors of stroke  How do we know we have it?  Symptoms  Diagnosis  Can it be treated?  What Next?  Learning more info on AF  Questions

4. What is Atrial Fibrillation?  Atrial fibrillation (AF) is a condition involving an irregular heart rhythm (arrhythmia) in the upper chambers of the heart, called atria.  The heart pumps in response to electrical signals. The normal heart has regular organized signals.  If you have AF those signals are rapid and irregular. The heart may not pump as efficiently. It can also beat very fast. Source: University of Toronto Atrial Fibrillation Teaching Site. http://afib.utorontoeit.com/http://afib.utorontoeit.com/

5. Who does AF affect?  AF is the most common type of arrhythmia, affecting approximately 350,000 Canadians. (It is estimated that Atrial Fibrillation affects 1 to 2% of the population.)  After the age of 55, the risk of AF doubles with each decade of life.  Having diabetes, high blood pressure or underlying heart disease increases your risk of developing AF.

6. How does AF affect you?  AF is a serious condition and can reduce your quality of life  Palpitations  Fatigue  Shortness of breath  AF significantly increases your risk of stroke 3 to 5 X Risk of Stroke

7. How does AF affect you?  AF causes 15% of all strokes  Stroke related to AF can be more severe. One study found:  60% are disabling  20% are fatal  Good news - your risk can be reduced by taking blood thinner medications (anticoagulants)

8. Stroke What is stroke?  A stroke is a sudden loss of brain function. It is caused by: 1.the interruption of blood flow to the brain (ischemic stroke) or 2.the bursting of blood vessels in the brain (hemorrhagic stroke)  Stroke has many risk factors. Some of these risk factors you can control and others you cannot control. ischemic strokehemorrhagic stroke

9. Stroke: risk factors you can control Stroke High Blood Pressure High Blood Cholesterol Smoking Stress Physical Inactivity Excessive Alcohol Consumption Being Overweight Diabetes Atrial Fibrillation

10. Stroke: risk factors you cannot control Stroke Gender Family History Ethnicity History of stroke or TIA (mini- stroke) Age

11. Atrial Fibrillation and Stroke Video

12. How do we know we have AF? Symptoms of AF  Irregular and fast heartbeat  This often goes undetected and it could mean an increased risk of stroke.  Heart palpitations or a rapid thumping in the chest  Chest discomfort, pain or pressure  Shortness of breath, particularly with exertion or anxiety  Fatigue, dizziness, sweating, or nausea  Lightheadedness or fainting

13. Symptoms Video

14. How do we know we have AF? Diagnosis of AF  If your pulse is fast and your heartbeat irregular, your doctor may check for atrial fibrillation. Your doctor will take your medical history and ask you for details about the condition and risk factors.

15. How do we know we have AF? Checking Your Pulse  Pulse = heartbeats/minute.  Measuring your pulse can get very important information about your health.

16. How do we know we have AF?  Several tools may be used to diagnose AF, including: Stethoscope Electrocardiogra m (ECG) Echocardiogram Holter and event monitors

17. Can AF be treated?  AF symptoms can be managed: 2 main strategies Medications may be used to restore and maintain a normal regular heartbeat. Some patients may require a controlled electric shock to the heart (electrical cardioversion) to restore a normal rhythm. Rhythm control Medications may be used to slow the heart rate. Rate control

18. Can AF be treated? Stroke risk can be reduced:  Most patients will be prescribed a blood thinner  Other stroke risk factors will be carefully managed

19. Treating non-responsive cases  Some people with AF do not respond to medication or cardioversion and may be treated with catheter ablation instead.  Catheter Ablation A catheter is inserted into the heart muscle. The catheter uses heat to cause tiny burns that destroy the tissue causing AF.  A new treatment called the Arctic Front Cardiac CryoAblation Catheter system uses a coolant instead of heat. By freezing the tissue, the abnormal electrical activity that causes AF is blocked. Source of image: The New England Journal of Medicine blog site.

20. Treatment Video

21. Preventing AF  Get your pulse checked  Know and control your blood pressure  Know and manage your cholesterol  Maintain a healthy weight  Limit your alcohol intake  Stay physically active  Quit smoking  Reduce your stress heartandstroke.ca/healthyliving For more info, visit:

22. What next?  If you are experiencing AF symptoms, visit your doctor.  If you have risk factors for AF, ask your doctor to assess you.  On a regular basis, ask your doctor to check your pulse.

23. Learn More  To learn more about Atrial Fibrillation visit our website at: heartandstroke.ca/bepulseaware

24. Any Questions?

25. Thank you.