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Atrial Fibrillation

Dr. Abhimanyu Beri discusses what causes atrial fibrillation, how it affects the body, how it's diagnosed and treatment options available.
Atrial Fibrillation
Abhimanyu Beri, MD
Dr. Abhimanyu Beri is board certified in internal medicine, cardiology and cardiac electrophysiology and has authored 19 peer-reviewed medical publications. He is a member of the Heart Rhythm Society. Dr. Beri received his Doctor of Medicine from the Maulana Azad Medical College in New Delhi, India. He went on to complete a residency in internal medicine from Michigan State University followed by a fellowship in cardiovascular medicine at Loma Linda University and a fellowship in clinical cardiac electrophysiology at Kaiser Permanente, both in California. Dr. Beri specializes in atrial fibrillation ablation as well as performing catheter ablation without any X-ray use.

Alyssa Diaz (Host):  Hello listeners and welcome to the Well Within Reach podcast. I'm your host Alyssa Diaz, and today we will be talking to one of Riverside’s heart experts on a very common condition that many adults experience called atrial fibrillation. But first, let’s go ahead and introduce our specialist Dr. Abhimanyu Beri, a clinical cardiac electrophysiologist at the Riverside Heart and Vascular Institute. Welcome to the podcast Dr. Beri.

Abhimanyu Beri, MD (Guest):  Thank you for having me. Glad to be here.

Host:  Dr. Beri, let’s first talk about your training and your role as an electrophysiologist.

Dr. Beri:  So an electrophysiologist is like an electrician. The heart is a complex organ. Imagine it like a complex pump. It needs a plumber, there's an electrician, and there's a lot of different systems that make the heart work. I am an electrician which is working on the rhythm of the heart to make sure it keeps beating in sync. So my training enables me to help diagnose and treat conditions that may be arising as a result of problems in the electrical system of a patient’s heart.

Host:  Very good. So very relevant to today’s topic of atrial fibrillation. Dr. Beri, I read from the American Heart Association that at least 2.7 million Americans are experiencing atrial fibrillation. So let’s start at the basics. What is atrial fibrillation?

Dr. Beri:  Atrial fibrillation is a condition where the top part of the heart, which are the atria hence the name, are fibrillating which is quivering. In the normal sequence of events, the top and the bottom of the heart should be beating in sync. In certain people who develop this condition, the top part starts quivering and beating out of order which causes a desynchrony or lack of coordination between the top and bottom portion of the heart. That has certain implications.

Host:  Just to clarify. Atrial fibrillation is different than heart palpitations.

Dr. Beri:  Yeah. So heart palpitations is a symptom. It Is what you feel. It may be from atrial fibrillation, but it could also be from seeing a loved one after a long time. It could be from skipped beats in the heart or it could be some other heart electrical problem. So palpitations are a symptom which may be a consequence of atrial fibrillation.

Host:  Okay. Then back to atrial fibrillation, what are some of the causes behind atrial fibrillation in patients?

Dr. Beri:  Causes for atrial fibrillation are multifold. Besides this coronavirus pandemic that we’re living through, we also have an epidemic of unhealthy lifestyles and obesity that is precipitating a lot of this problem. So the common causes are genetics, being diabetic, untreated sleep apnea, obviously being overweight and obesity which is rampant around our country, alcohol consumption in large quantities, history of congestive heart failure. The list is long, but these are the most common conditions that can precipitate or cause atrial fibrillation.

Host:  Are there certain individuals that are at higher risk? Say men or women or after a certain age.

Dr. Beri:  Yes. So atrial fibrillation does get more frequent as you get older. In fact, in a person atrial fibrillation does get more common when you get older. The percentage of people who are above 80 who have atrial fibrillation is sizeable. It’s not negligible. It may be as high as 10% of even higher.

Host:  Okay. Now we know what atrial fibrillation is and what some of the causes and can be. So how does atrial fibrillation, or also a lot of people called it a-fib, effect the body?

Dr. Beri:  It is fascinating. When we see a plethora of patients with atrial fibrillation with a wide spectrum. Some have no idea that they’re in atrial fibrillation. Their body does not even recognize the fact that they’re in atrial fibrillation. They continue to work well. Unfortunately, like a lot of other chronic medical conditions like diabetes and high blood pressure, it can be a silent killer. So the first symptom from atrial fibrillation may be a stroke. That risk goes up as people get older. It’s higher in women. A history of congestive heart failure, diabetes, a history of a previous stroke. All of these previous things put you at a higher risk for having another stroke from atrial fibrillation. The other more common symptom is symptoms of palpitations, feeling your heart racing, shortness of breath, fatigue, lightheadedness, dizziness. Sometimes chest pain can result from atrial fibrillation. Over time, untreated atrial fibrillation can lead to the heart valves becoming leaky and lead to congestive heart failure.

Host:  So it’s definitely something that needs attention and needs treatment. When somebody has atrial fibrillation, how do you diagnose that?

Dr. Beri:  Often atrial fibrillation is diagnosed when patients present either to their doctor or to the emergency room with the symptoms that we discussed before. This is easily diagnosed on an electrocardiogram, which is an EKG that many of you must be familiar with. Sometimes the symptoms are sporadic, which means they can come and go. At which time a heart monitor may be required. This could be for 24/48 hours up to 30 days and rarely we may have to implant a chip in someone’s chest to pick up these episodes of palpitations or atrial fibrillation.

Host:  That’s something as an electrophysiologist that you study the results of in order to help your patients.

Dr. Beri:  Yes. We review the results of this in great detail because these are very important for us to help diagnose the condition, find what the problem is, and treat for the patients.

Host:  Let’s talk about treatment. What are some of the treatment options available?

Dr. Beri:  The first thing about atrial fibrillation is to recognize the risk of stroke and how can we lower the risk of stroke. Stroke is very devastating and can be a life changing condition. We absolutely do not want our patients having strokes. Blood thinners are one way of treating the risk of stroke. The alternative is a therapy called a Watchman device, which we may talk later. The blood thinners are important because they thin the blood. The reason why people with atrial fibrillation get strokes is because blood flows very slowly when the heart is not pumping normally but instead just quivering. Regarding the symptoms of atrial fibrillation, there are medications that can be used to slow the heart rate down. We have state of the art technology here at Riverside where we can actually treat the condition with either advanced medications or with what’s called catheter ablation where we can insert a catheter inside a person’s body and find the areas that are causing atrial fibrillation until we can get rid of them completely and get rid of the problem.

Host:  So there are a number of options available for patients. Really, it’s something that patients can decide with you or their doctor on what treatment option is best for them.

Dr. Beri:  Yes absolutely. Treatment needs to be individualized to every patient. Not everyone is the same. We cannot ignore the symptoms of one versus the other. We definitely encourage patients to meet with their doctor. We are always available for consultation to help guide the most appropriate care for our patients.

Host:  Dr. Beri, thanks for joining us on the Well Within Reach podcast. How might individuals seek care for conditions like atrial fibrillation or other cardiovascular conditions?

Dr. Beri:  If you have any concerns about your heart, we are always available. Talk to your doctor, and you can always contact us online at or 844-404-HRTS.

Host:  Thank you Dr. Beri. That concludes this Well Within Reach podcast.