Patient/caregiver was educated on pathophysiology of atrial fibrillation as follows:
- Heart has a natural pacemaker, SA node, which initiates the impulse for a heartbeat.
- The impulse initiated in the SA node, with the help of other conductive tissues, spreads along the rest of heart muscle, thus helping with the programmed opening and closing of heart valves, organized contraction of individual heart chambers, and preventing any disturbance to the normal blood flow.
- In a healthy heart with normally functioning SA node, the beats are evenly spaced out, at a rate of 60 – 100 beats/minute. This evenly spaced out pattern of heartbeats is called the normal heart rhythm or sinus rhythm.
- Atrial fibrillation is a pathological condition, in which this normal sinus rhythm is disturbed. During atrial fibrillation, the impulse for the contraction of heart is initiated from multiple sites of damaged heart muscle in and around the atria or upper chambers of the heart. This abnormal rhythm can be prominent and dominate the normal rhythm initiated in the SA node.
- Damage to the atrial heart muscle could be due to various factors, such as, excessive cholesterol deposition, reduced blood flow to heart muscle, history of heart attack (myocardial infarction), and many more.
- Scar tissue formed during healing of the damaged cardiac tissue can inhibit normal conduction of impulse and result in abnormal route of conduction of cardiac impulse, thus resulting in arrhythmia.
- In atrial fibrillation, the impulses that originate in multiple sites of damaged heart tissue in the atria give rise to an irregular, abnormal, rapid, and chaotic rhythm, at a rate of more than 300 beats per minute.
- Effective and organized contraction of heart chambers is important for normal blood flow and adequate pumping of blood by heart to vital organs. Irregular and chaotic rhythm of atrial fibrillation results in ineffective and abnormal contractions of the heart chambers.
- Ineffective and abnormal contractions of the heart chambers result in compromised output of oxygenated blood volume from the heart and reduced flow to vital organs, thus affecting their function.
- This abnormal heart rhythm could be temporary with normal rhythm restored or could be persistent needing management with medications.
