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Lone
Atrial Fibrillation (LAF)
Michael Lam, MD, MPH
www.DrLam.com
(READING
TIPS: For fast reading, scan through the topic headings in BOLD BLACK, important conclusions in BOLD BLUE, and "Must Know" in BOLD RED. To jump to specific sections in this article, click on
the respective LINKS in the Contents.)
| Before You Begin
Information presented here is for general
educational purposes only. Each one of us is biochemically and metabolically
different. If you have a specific health concern and wish my personalized
nutritional recommendation, write to me by clicking here. |
Contents
Introduction
Normal
Conduction Versus Atrial Fibrillation
The
Heart With AF
Autonomic
Nervous System (ANS)
Diagnosis
of Lone Atrial Fibrillation (LAF)
Causes
of LAF
Mitochondria
and LAF
Drug-Based
Treatment of LAF
Traditional
Medical Approach - Treatment of Choice?
How
the Chinese Cure LAF
The
Best of Western and Eastern Medicine
LAF
Prevention Protocol
1.
Prevent Cellular and Mitochondria Oxidative Stress
2.
Enhance Mitochondria Function
Coenzyme
Q10
L-Carnitine
Lipoic
Acid
Hawthorn
Berry
Magnesium
3.
Strengthen the Cardiac Muscle Function
4.
Reduce Stressors Graduall
5.
Reduce Cardiac Workload Gradualy
6.
Avoid Sugar Imbalance Gradualy
7.
Prolong the Life of the Hat
8.
Avoid Sleep Imbalances ad Deprivation
9.
Maintain Hydration but Avoid Sudden Hydration Imbalances
10.
Maintain a Toxin-free Body
11.
Listen to Your Body Carefully
12. Reduce Sub-clinical Infection
Summary
Introduction
 Atrial
Fibrillation (AF) is an abnormal irregular and fast heart rate where electrical
signals are generated chaotically throughout the upper chambers (atria)
of the heart.
AF is common in the elderly. Its prevalence, estimated to be 2.3 percent
in those over 40, increases to 5.9 percent in people 65 years and older.
By age 70, 10 percent have this heart rhythm disorder. Seventy
percent of the people who have AF are between 65 and 85 years old. It
affects over 2 million Americans and is the cause of about one-third of
all strokes in people over the age of 65. It is the most frequently diagnosed
arrhythmia in the clinical setting.
Most of the older patients with AF have associated hypertension, ischemic
heart disease, congestive heart failure, and underlying conditions such
as mitral valve disease, hyperthyroidism, and pulmonary disease. In some
families, AF appears to have an inherited basis
(although most people with AF do not have an inherited form).
In those under 40, the prevalence of AF is estimated to be less than 0.004%.
AF in younger and active patients is more likely to be a manifestation
of congenital heart disease, hyperthyroidism, excess alcohol or other drug
use, including caffeine, and exercise-induced catecholamine release. In
this group, the exact cause often cannot be found. Such cases are labeled
Lone Atrial Fibrillation.
Let us
first understand the basics of how electrical conduction works in the heart.
Normal Conduction Versus Atrial
Fibrillation
The heart is a pump that needs an electrical system to trigger to keep the
chambers contracting in a coordinated fashion. To do that, the heart has
its own built-in pacemaker called the SA node (Sino-atrial node) located
on the wall of the right atrium. It sends out impulses at about 60 to 100
beats per minute, to both the right and left upper chambers (atria) of the
heart, telling them the exact moment to beat. The SA node sets the rate
the heart beats to meet the body's demands: slow at rest, and fast during
excitement.
From the SA node, the impulse travels through the AV node (atrial-ventricular
node), the "gatekeeper" of impulses, to the lower chambers of the heart
(ventricles) via the bundle of His, telling the ventricles it's their turn
to beat. The sequence of this electrical
event causes the atria to beat first and a split second later, the ventricles
to beat. This is the normal sinus rhythm characteristic of a normal functioning heart.
The Heart With AF
During AF, the normal sinus rhythm is disrupted by a very rapid, uncontrolled,
and disorganized rhythm. The normal flow of electricity activity is
upset by what can be best described as numerous little tornadoes wandering
about in the atria. Instead of initiation of conduction from the SA node
to the AV node in the normal sinus rhythm, the atrium's activity proceeds
instead as multiple wavelets. Consequently, the
atria beat so rapidly (as fast as 300 to 350 beats per minute) that they
quiver (fibrillate). Such fibrillation does
not result in effective contraction of the atrial muscles and therefore
the pumping action at the atria is not strong. In addition, the rapid atrial
rate effectively overrides any activity from the SA node. In other words,
these rapid wavelets take control of the atrium. Most of these rapid wavelets
are non-productive. Some of them reach the AV node, and then onto the ventricles.
This causes the ventricles to pump in a rapid and irregular pattern in response
as well. The heart with AF beats irregularly
and there is no consistent pattern to such irregularity.
Autonomic Nervous System (ANS)
The Autonomic Nervous system controls the internal workings of the body
and maintains its homeostasis. It is responsible for many bodily functions,
including regulating heart rate, blood pressure, and digestive system. It
originates in the hypothalamus region of the brain from where it divides
into two branches - the sympathetic (adrenergic) branch and the parasympathetic
(vagal) branch. The neurotransmitter used in the adrenergic branch is norepinephrine
(noradrenaline) and in the parasympathetic system is acetylcholine.
Norepinephrine increases muscle contractions and heart rate, while acetylcholine
does the reverse. By continuously self-adjusting the secretion of these
two neurotransmitters, the body is kept in perfect balance and the heart
produces normal sinus rhythm. In times of stress or emergency, the body
has a backup system of releasing more adrenergic neurotransmitters (epinephrine
and norepinephrine), allowing the execution of the "fight or flight" response
necessary for survival. Such extraordinary release and/or excessive stimulation
of adrenergic neurotransmitter often act as a trigger factor for AF.
When the ANS is imbalanced, AF can be the result.
AF can be vagally mediated or sympathetically mediated. Vagally mediated
atrial fibrillation typically is preceded by slow heart rate (bradycardia),
is not triggered by stress, occurs more often at night, is more common in
men, and occurs at a younger age. Sympathetically mediated atrial fibrillation
is less frequent, typically occurs during the day, and can be triggered
by stress. The heart rate in sympathetically mediated atrial fibrillation
is higher before and during the episode in comparison with the vagal type.
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