Atrial fibrillation (AF or A-fib) is the most common cardiac arrhythmia (abnormal heart rhythm.) It’s a common cause of irregular heartbeat, identified clinically by taking a pulse.
Chaotic electrical activity in the two upper chambers (atria) of the heart result in the muscle fibrillating (i.e. quivering), instead of achieving coordinated contraction. The presence of AF can be confirmed with an electrocardiogram (ECG or EKG) by the absence of P waves and an irregular ventricular rate.
Presence of AF in a population increases with age, with 8% of people over 80 having AF.
Some people are asymptomatic despite having frequent episodes, while others experience symptoms that are troubling or incapacitating. Whilst AF is not immediately life-threatening, it may result in palpitations, fainting, chest pain, or congestive heart failure.
People with AF have an increased risk of stroke because blood tends to form clots in the poorly contracting atria – especially in the left atrial appendage (LAA). The degree of stroke risk can be up to seven times that of the average population, depending on the presence of additional risk factors. In the absence of other risk factors, the risk of stroke in AF patients is similar to that of the general population.
Atrial fibrillation may be treated with medications to either slow the heart rate or revert the heart rhythm back to normal. Synchronized electrical cardioversion can be used to convert AF to a normal heart rhythm. Surgical and catheter-based therapies may be used to prevent recurrence of AF in certain individuals. People with AF often take anticoagulants to protect them from stroke.
Let’s review a case study:
- Female, 58 years old, NS
- Seeking $1 million UL
- Diagnosed with Chronic Atrial Fibrillation four years ago.
- Treated with low doses of Flecainide
Initial work-up was a Table 2.
With applicable credits, such as:
- Great family history
- Regular preventative care
- Controlled blood pressure
- Income greater than $100,000
- Preferred driving record
Offer – Tentative Standard
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