Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Atrial fibrillation can be diagnosed by physical examination, electrocardiogram, Holter monitor, or patient-activated event recorder.
AFib is directed toward controlling underlying causes, slowing the heart rate and/or converting the heart to normal rhythm, and stroke prevention using blood-thinning medications.
Medications are commonly used in the longer term to control or prevent recurrence of
AFib, but medications may not be effective and may have intolerable side effects.
Electrical cardioversion is successful in over 95% of patients with
AFib, but 75% of patients have a recurrence of AFib within 1 to 2 years.
Some doctors may leave patients in
AFib for the longer term provided the heart rate is under control, blood flow is adequate, and blood is adequately thinned with medications.
Non-medication treatments of atrial fibrillation include pacemakers, AV node ablation, atrial defibrillators, and the Maze procedure.
Pulmonary vein isolation shows promise for the treatment of atrial fibrillation and has a high rate of success; however, longer-term experience is necessary.
What is atrial fibrillation (AFib)?
Atrial fibrillation (AFib) is the most common, abnormal rhythm of the heart.
The heart contracts (beats) and pumps blood with a regular rhythm, for example, at a rate of 60 beats per minute there is a beat every second. The heart may beat faster or slower with a shorter or longer interval between beats, but at any one rate the interval between beats is constant. This regular rhythm occurs as a result of regular electrical discharges (currents) that travel through the heart and cause the muscle of the heart to contract. In
AFib, the electrical discharges are irregular and rapid and, as a result, the heart beats irregularly and, usually, rapidly.
Atrial fibrillation is common; half a million new cases are diagnosed yearly in the U.S., and billions of dollars are spent annually on its diagnosis and treatment.
An irregular heartbeat is an arrhythmia (also called dysrhythmia). Heart rates can also be irregular. A normal heart rate is 50 to 100 beats per minute. Arrhythmias and abnormal heart rates don't necessarily o"...