A Plan of Care for People Living With Atrial Fibrillation


A Plan of Care for People Living With Atrial Fibrillation

Atrial Fibrillation Care Plan

Atrial Fibrillation (AFib) is the most widespread cardiac arrhythmia worldwide, affecting men more often than women, and is most common in people aged 65 to 85. If you are living with AFib, you likely have questions about your atrial fibrillation care plan and what you can do to live an active, purposeful, and enjoyable life.

Living well with AFib requires a two-pronged approach of effective medical management and proper self-care.

Medical Management Care Plan of AFib

Your physician develops your individualized AFib treatment plan after gathering and reviewing details about such factors as past medical history, circumstances surrounding your first episode, reversible causes, the level of your current heart function, and the presence of other possible contributing conditions.

Your comprehensive atrial fibrillation care plan focuses on the areas of heart rate control, heart rhythm control, and anticoagulation.

Heart Rate Control

The goal with heart rate control is to keep your pulse at 80 beats a minute or lower at rest and under 110 during exercise. Maintaining pulse rates at these levels reduces heart muscle workload and strain.

Your physician will regulate your pulse with one of two options: a pacemaker or medication. People who have AFib that is resistant to heart rate control often receive an implanted pacemaker.

Two separate classes of medications recommended for rate control of AFib are beta blockers and calcium channel blockers.

  • Beta-blockers prevent the release of adrenaline, which causes a decrease in pulse rate, blood pressure, and heart muscle workload.
  • Calcium channel blockers do what they say – they block calcium’s access to the areas of the heart where electrical conduction takes place, and thereby decrease its contraction force.

Heart Rhythm Control

Converting the heart rhythm from AFib back to normal is necessary to ensure the return of the heart’s pre-AFib pumping capacity. Your physician’s choice of treatment will depend on your type of AFib as well as your particular signs and symptoms.

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The American Heart Association’s 2015 Treatment Guidelines of Atrial Fibrillation list four options for returning AFib to a normal heart rhythm:

  • Antiarrhythmic medications such as amiodarone, flecainide, and sotalol that demonstrate a high success rate of converting AFib back to a normal rhythm.
  • Rhythm correction with electrical cardioversion for people experiencing critical symptoms like severe shortness of breath or chest pain.
  • Catheter ablation, a minimally invasive procedure involving burning microscopic regions of the heart responsible for producing the irregular electrical signals that trigger AFib.
  • Surgical techniques including a MAZE, which involves making small cuts in the atria to interrupt AFib’s electrical path, or a Left Atrial Appendage Closure with a miniature inserted device to prevent the formation of blood clots.

Anticoagulation

Every individual needs to have their risk of blood clots assessed regardless of a physician’s symptom treatment strategy.

Your doctor uses a scoring system called CHADS2 to evaluate your risk for blood clot formation and stroke. Your score determines whether the physician prescribes an anticoagulant medication and which one is the best for you.

Some of the most common anticoagulants used for AFib include:

  • Aspirin
  • Warfarin
  • Dabigatran
  • Rivaroxaban
  • Apixaban
  • Edoxaban 

The Self-Care Plan for AFib

Following a healthy lifestyle helps manage and reduce the frequency of AFib episodes. One of the most important steps to take is to make changes to your daily habits that will lower your risk for recurrent AFib and help control or prevent other conditions like diabetes, obesity, elevated cholesterol, and high blood pressure.

Making wise decisions such as eating healthy, exercising, stopping smoking, managing stress, and educating yourself about AFib will work hand-in-hand with your doctor’s treatment plan.

Nutrition

Take charge of your diet and choose heart-healthy foods like lean meats and fish, fresh or frozen fruits and vegetables, legumes, omega-3’s and monounsaturated fats, and non-GMO whole grains. Eliminate as many processed foods, refined grains, and sugar-filled products as possible, and cook at home most of the time.

  • Shop for food in the outer perimeter of the grocery store, which is the area containing fresh meats, fruits, and vegetables.
  • Use this simple weight management rule for lunch and supper meals: fill your plate with a palm-sized serving of protein, a fist-sized helping of carbohydrates (starches), and use the rest of the space for vegetables.
  • Consume only a small amount of alcohol and caffeine, as both are known to trigger AFib episodes.

Exercise

Find out your physical activity guidelines and limitations from your physician, and ask for written instructions to follow. Better yet, request a referral to a medically supervised exercise program, like cardiac rehab, which employs degreed and certified exercise professionals.

An exercise professional will tailor a program to your specific needs that address the following areas:

  • Cardiovascular (aerobic) endurance
  • Strength
  • Flexibility
  • Balance
  • Training mode, frequency, intensity, time, and progression
  • How to self-monitor your intensity

Smoking Cessation

Studies published by both The Heart Rhythm Journal and the National Center for Biotechnology Information show that smoking raises the incidence of AFib. If you smoke, quitting will dramatically lower your risk of future events.

Your doctor has several different proven options to help you give up tobacco for good including:

  • Nicotine patches, lozenges, or gum
  • Medications like bupropion and varenicline
  • Referral to a smoking cessation program
  • A combination of these three

Stress Management

Managing your mental health is important because feelings of anger and high stress can trigger AFib. Developing an AFib care plan for handling your emotions will help you to cope with the challenges of life.

Building a network family, friends, neighbors, and co-workers to turn to for support will help you deal with your emotions during times of crisis. Your doctor can also schedule a consultation with a licensed mental health professional to help you work through stressful times.

Education

Learning as much as you can about AFib will help you to understand the condition better and allow you to make wise decisions about your care. Consider implementing these strategies:

  • Take a list of four or five brief but specific questions to each appointment with your health care providers, and have paper and pencil ready to write down their feedback. Remember – questions are the answer!
  • Read information about AFib produced from trusted sources.
  • Sign up for AFib support groups, classes, health fairs, and other community education events that your local healthcare facility sponsors.
  • Talk to other A-Fibbers that “know the ropes,” especially health professionals that have the condition.

Your atrial fibrillation care plan centers on your health and well-being and consists of two essential parts: your physician’s care and the care you give to yourself. You and your doctor(s) are partners – working together as a team will provide you with the best opportunity to live well with AFib.

Resources

American Family Physician (Atrial Fibrillation: Diagnosis and Treatment)

American Heart Association (Atrial Fibrillation Treatment Guidelines 2015)

Mayo Clinic (Atrial fibrillation – Self-management)

Medscape (Atrial Fibrillation Treatment & Management: Approach Considerations)

NCBI-NIH (The Current Approach of Atrial Fibrillation Management)

NRSING (Nursing Care Plan for Atrial Fibrillation)

Nursing Times (Management of atrial fibrillation)

The Heart Rhythm Journal (Smoking and incidence of atrial fibrillation)

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764 found this helpfulby Patricia Bratianu on September 15, 2015
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