Atrial fibrillation (AFib) is an irregular heart rhythm characterized by rapid, uncoordinated beating of the heart’s upper chambers, the atria. This abnormal electrical activity can lead to inefficient blood pumping. Whether AFib requires hospitalization depends on several factors healthcare professionals evaluate.
Factors Determining Hospitalization
Hospitalization for AFib is often determined by a patient’s symptoms and clinical stability. Individuals experiencing their first AFib episode, especially with severe symptoms like chest pain, severe shortness of breath, dizziness, or fainting, typically require hospital admission for evaluation and management. This also applies if a patient with a known AFib diagnosis feels significantly unwell or shows signs of a heart attack or stroke.
Hemodynamic instability, such as very low blood pressure or signs of shock, necessitates immediate hospitalization. A heart rate consistently above 120 beats per minute at rest, indicating rapid ventricular response, can also lead to admission as it may not adequately pump blood, potentially leading to heart failure. Underlying heart conditions like congestive heart failure or coronary artery disease, or serious comorbidities, also increase hospitalization likelihood. If outpatient treatments fail to control symptoms or restore rhythm, or if there’s a high stroke risk requiring immediate blood thinner initiation under observation, hospitalization may be indicated. Urgent procedures like cardioversion, which resets the heart’s rhythm, may also require a hospital setting.
What to Expect During Hospitalization
Upon admission for AFib, diagnostic tests are typically performed to assess the heart’s condition and identify underlying causes. These often include an electrocardiogram (ECG), which records the heart’s electrical activity, and an echocardiogram, an ultrasound of the heart to evaluate its structure and function. Blood tests are also conducted to check for conditions that might influence heart rhythm or treatment.
The primary goals of treatment during hospitalization are to control heart rate, restore a normal rhythm if appropriate, and prevent stroke. Medications like beta-blockers or calcium channel blockers are commonly administered to slow a rapid heart rate, while antiarrhythmic drugs may help restore a regular rhythm. If medications are ineffective or symptoms are severe, electrical cardioversion, a procedure delivering controlled electrical shocks to the heart, may be performed to reset the rhythm. Continuous ECG monitoring observes the heart’s activity. Patients also receive education about AFib, medication management, and lifestyle adjustments to support long-term health before discharge.
Managing AFib Without Hospitalization
AFib can often be managed outside a hospital setting, particularly for stable patients without severe symptoms. Outpatient management is considered safe and appropriate for individuals with known AFib who are asymptomatic or have only mild symptoms, and who do not show signs of acute complications like heart failure or stroke. It is also suitable when good follow-up care is readily available to monitor their condition.
Outpatient management typically involves adjusting existing medications to control heart rate or rhythm, or initiating new prescriptions. Lifestyle modifications, such as regular exercise, a heart-healthy diet, and managing underlying conditions like high blood pressure or sleep apnea, are also emphasized. Consistent communication with a healthcare provider and strict adherence to the prescribed treatment plan are paramount to control the condition and prevent complications.