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Treating atrial fibrillation: Not all patients alike

​​​​​​​Television or magazine advertisements about treating atrial fibrillation (a-fib) may imply that the heart rhythm condition can be isolated and treated alone. 

Albert Schultz, Rice Lake Albert Schultz, Rice Lake

Because many different causes can lead to a heart rhythm problem, it's important to consider total heart health during treatment. Rice Lake resident Albert Schultz, 70, is enjoying life with a-fib thanks to the help of his doctor and a comprehensive approach to his heart care.

Schultz experienced a sudden rapid heartbeat more than 10 years ago. "I went to the hospital in Rice Lake and was transferred to the hospital in Marshfield," he said. "Three heart blockages were discovered and surgically treated. While I was recuperating, the atrial fibrillation developed. I've been battling it ever since."

The heart has an electrical system, which causes the heart to pump blood. A-fib is a heart rhythm disturbance in that electrical system. It may be considered paraoxysmal (par-ok-SIZ-mal), a faulty heart rhythm that begins and ends on its own, usually in less than 24 hours. A-fib also may be persistent, lasting longer than a week but correctable with treatment. A third type of a-fib is considered permanent, a condition that cannot be corrected by treatment. Schultz's a-fib is paraoxysmal.

"Prevalence for atrial fibrillation increases with age," said Schultz's cardiologist, Param Sharma, M.D.​​, Marshfield Clinic Heart Care, Eau Claire and Marshfield Centers. "But many patients have an underlying cause such as high blood pressure, heart muscle weakness, or coronary artery disease or valve heart disease. This requires a comprehensive approach to managing the effects of the arrhythmia and the chronic condition affecting overall heart health."

Patients may become aware of a heart rhythm problem from symptoms they can feel such as an unusually rapid heartbeat, erratic beats or shortness of breath. Heart rhythm disturbances also may develop following heart surgery.

"If these symptoms persist without treatment, over time heart muscle weakness may develop or the disturbance could lead to a stroke," said Dr. Sharma. "A-fib diagnosis is confirmed by doing an electrocardiogram (EKG), a test that checks the electrical activity, which controls the heartbeat."

Schultz does not physically feel his a-fib symptoms. However, he has an implanted pacemaker defibrillator, a device which regulates and records irregular heart activity. So, Schultz knows whether his body is experiencing a heart rhythm disturbance. "I can't feel the a-fib at all, but the reports tell me and my doctor it's there," he said. "When the reports show that my current treatment is no longer working, Dr. Sharma prescribes something different to help with controlling it."

Treatment for a-fib may include a combination of approaches to help control the rate at which the heart is beating and the regularity of the beats. "Depending on the patient's risk factors, we may use only medication," said Dr. Sharma. "In other patients, a less invasive procedure or surgery, combined with medication, may be needed. Our goal is to help reduce the risk of stroke and control the symptoms."

Schultz is retired and stays active by hunting, fishing and managing some forestland he owns. He and his wife, Buneé, have a thriving fish taxidermy business.

Like most a-fib patients, Schultz was unfamiliar with the condition when he was diagnosed.

"At first it's a shock," said Schultz. "It's your heart, so you're very concerned. But looking back, it's not something to fear. There is so much research happening that what is available today is much more than was available four to five years ago. I'm doing everything I want to do."