An irregular pulse and shortness of breath led to a 68-year-old being diagnosed with atrial fibrillation. Learn what happens in the heart, how the condition is detected, and why treatment is important

Irregular Pulse – What Was Wrong With the Heart?

A 68-year-old man was admitted to the hospital because his heartbeat had been irregular over the past week. He felt short of breath, especially during activity, and his pulse varied between 110 and 150 beats per minute.

To find the cause, an ECG (electrocardiogram) was performed – a test that records the heart’s electrical activity.The ECG showed that he had atrial fibrillation, a common heart rhythm disorder.

EKG revealed atrial fibrillation

What is Atrial Fibrillation?

In atrial fibrillation, the upper chambers of the heart (the atria) lose their normal rhythm.Instead of contracting in a regular pattern, they produce many small, uncoordinated electrical impulses that make the heart beat irregularly and often too fast.

On a normal ECG, you can see distinct small waves showing that the heart is beating in a steady rhythm. In this patient, those waves were missing, and the baseline appeared as irregular “noise.”When he later returned to normal rhythm, the characteristic small waves became visible again – a sign that the heart had regained its normal pattern.

Why Doesn’t the Heartbeat Get Even Faster?

Inside the heart, there is a small structure called the AV node. It acts as a kind of “gatekeeper” between the atria and the ventricles, allowing only a limited number of electrical impulses to pass through.Because of this, the heart rate rarely exceeds about 150 beats per minute, even though the atria may produce up to 600 impulses per minute.If all those signals were transmitted, the heart would beat far too quickly and wouldn’t have time to fill properly between beats.

AV-node allow only around 150 impulse/min from the atria to the ventricles

Symptoms of Atrial Fibrillation

The most common symptoms are an irregular heartbeat, shortness of breath, and reduced stamina.Some people also feel dizzy or experience a fluttering sensation in the chest.However, many have no symptoms at all, which means atrial fibrillation can go unnoticed for a long time.

Treatment and Outcome

The patient was already taking blood-thinning medication.He therefore underwent an electrical cardioversion – a short procedure in which a brief electrical shock is delivered under anesthesia to restore a normal rhythm.After the procedure, his heart returned to its usual rhythm, known as sinus rhythm, and his symptoms disappeared.

Restoration of sinus rythm. Red circle shows the organized atrial activity.

Why is It Important to Detect Atrial Fibrillation?

Atrial fibrillation is not dangerous in itself, but if left untreated, it can lead to complications such as stroke and heart failure.A simple ECG can make the diagnosis, and proper treatment greatly reduces the risk.

If you notice an irregular pulse, heart palpitations, or shortness of breath, you should contact your doctor for an evaluation.