1. Houston--I think I've got a Problem
Normally, the heart's "pacemaker" initiates a heart beat. The pacemaker is a collection of cells lying between the heart's upper chambers, the atria, and its lower chambers, the ventricles. In the case of atrial fibrillation, instead of the pacemaker, cells within the atria fire off, initiating beats. These cells discharge at a rate of up to 300 beats per minute. Atrial fibrillation is an irregular heart rhythm that leaves people with the impression that their hearts are about to jump out of their chests. Heart rates can be exceedingly irregular and as fast as 150 beats per minute.
2. Causes
The most common cause of atrial fibrillation is heart disease. Following a heart attack, scarred cells can be "irritable," prone to firing off on their own. Any factors that make the myocardium irritable can also cause atrial fibrillation: heavy alcohol use, recreational stimulants like cocaine and amphetamines, an overactive thyroid gland, or oxygen deprivation as is seen with sleep apnea. Some people have a genetic predisposition because the electrical conduction system of their hearts have short circuits.
3. Treatments
There are three basic kinds of treatments for atrial fibrillation: medication, electricity and surgery. Faced with a choice between being shocked, carved up or taking a pill, obviously, most people prefer pills. But treatment goals ultimately determine which treatments are appropriate. These goals are conversion of a patient's rhythm back to a normal "sinus rhythm," maintenance of a regular rhythm, establishing a slower rate of heart beats, or interrupting the "short circuits." The surgical procedures are now using radio waves to "ablate" short circuits.
4. P.A.T.
If atrial fibrillation feels like one's heart is about to jump out of his chest, paroxysmal atrial tachycardia (PAT) feels like a bar-room brawl right behind the sternum. It is technically not atrial fibrillation even though it too is an abnormal rhythm that starts in the atria. PAT is different because it involves what is called a "re-entry phenomena." This is a situation where a fast rhythm feeds on itself. The heart can beat at a rate of between 200 and 300 beats per minute. PAT also starts suddenly, thus its name.
5. Ref--It's not my Fault
In some people, the excitement and demands of athletics create a circumstance where PAT is more likely. This can even occur in professional athletes. Some athletes must take medications to cope with this circumstance. One NFL player, who later went on to become a physician, almost saw his career ended by recurrent PAT. The problem was not that his treatment was ineffective in controlling the PAT. The problem was that the medication used to treat the PAT made the player very mean. This might have actually been an advantage had the player not been an offensive lineman. He began setting records for penalties. His medicine was eventually changed.
