Atrial Fibrillation

Atrial fibrillation is a heart condition that can range in severity and may or may not produce symptoms. If chronic fibrillation significantly interferes with your ability to work, you may qualify for disability payments from the Social Security Administration (SSA).

What is Atrial Fibrillation?

Atrial fibrillation, or AFib, occurs when the two upper chambers of the heart, called the atria, beat rapidly and out of sync with the lower heart chambers, called the ventricles. This erratic heartbeat, or arrhythmia, can be an occasional occurrence or an ongoing, chronic condition that negatively affects blood flow. It can result in heart palpitations, weakness, shortness of breath, chest pain or fainting, and it can lead to heart failure or stroke. General treatment for AFib usually involves medication or possibly a pacemaker.

Atrial Fibrillation Symptoms

An erratic heartbeat, or arrhythmia, is the main symptom of atrial fibrillation. However, additional symptoms may be present in conjunction with the arrhythmia. These may include:

• Fatigue
• Confusion
• Fainting
• Dizziness
• Palpitations
• Shortness of breath
• Chest pain
• Anxiousness

Some people may feel no symptoms at all and may not be aware that their heart is fibrillating. Most, though, will be aware that something is awry when the heart begins beating rapidly.

Types of Atrial Fibrillation

There are various types of atrial fibrillation, but in 2014, the Journal of the American College of Cardiology determined that you can assess the type of AFib a patient has by ascertaining which of four types of arrhythmia the patient may present. By determining which of the four types of arrhythmia the patient presented, they were able to break down the number of atrial fibrillation types to four. The first four in the following list are the types found in the report.

• Paroxysmal atrial fibrillation: This type of AFib is the least severe. While presenting any of the symptoms associated with this condition warrants a visit to the doctor’s office, the paroxysmal arrhythmia typically lasts less than a week. The arrhythmia often comes and goes, but can be brought on again by stressors and other lifestyle choices.
• Persistent atrial fibrillation: This type lasts longer than paroxysmal AFib and may need to be treated with medicine to keep it under control. Sometimes a more serious treatment is necessary like electrical cardioversion, which uses low-voltage electricity to restart the heart’s rhythm to force it to go back to normal.
• Long-standing atrial fibrillation: If the arrhythmia lasts for more than a year without stopping, the type of AFib is considered to be long-standing. The treatment that may be successful with persistent AFib will probably not work with this type. If a person is diagnosed with long-standing AFib, there’s a good chance that there’s structural damage to the heart.
• Permanent atrial fibrillation: Once the arrhythmia is chronic, the AFib is considered to be permanent. With this type of AFib, treatment is ineffective. There’s a much higher risk of stroke or other cardiac attack once it becomes chronic. A long-term plan with medication is typically the best course of action as it stabilizes the heart rate and minimizes the major cardiac risks.
• Valvular atrial fibrillation: When a problem with the heart valve is what’s causing the arrhythmia, it results in valvular AFib. While a pre-existing heart valve disorder may be cause for this type of AFib, a person may develop this type of condition if they have a prosthetic or artificial valve. Stabilizing the heart rate and minimizing blood clots are typically the best course of treatment for this type of atrial fibrillation.
• Nonvalvular atrial fibrillation: This type of AFib develops in people that don’t have problems with their heart valves. Nonvalvular AFib may be caused by high blood pressure or other lifestyle choices. Treatment can either come in the form of medication or procedures like cardioversion.
• Atrial fibrillation with rapid ventricular response: When an arrhythmia in the atria, or top two chambers of the heart, occurs at the same time as an arrhythmia in the ventricles, or bottom two chambers of the heart, atrial fibrillation with rapid ventricular response (or AFib with RVR) occurs. This type can have minor symptoms like shortness of breath, but can also lead to stroke. Stabilizing the heart rate is the main course of treatment for this type of condition, but like the other types, procedures may be necessary for more severe cases.

Regardless of the type, if you feel your heart beating irregularly you should go see a doctor. While this condition can start from a paroxysmal arrhythmia, it can escalate to a more severe type of atrial fibrillation.

Atrial Flutter vs Atrial Fibrillation

While both conditions involve arrhythmias, a person with an atrial flutter does not necessarily have to have an irregular heartbeat. With AFib, the atria beats out of sync with the ventricles, which causes the erratic heartbeat. With an atrial flutter, the atria and the ventricles are in sync, but the atria beats faster than the ventricles. The heartbeats associated with an atrial flutter may go something like this: the atria may beat two times for every beat of the ventricles. The rapid beat of the atria could happen two, three, four, etc. times, but regardless of the number of times, it’s always more than that of the ventricles. The best way to tell the difference between an atrial flutter and an atrial fibrillation is through an ekg as each condition presents different patterns.

Atrial Fibrillation vs Ventricular Fibrillation

Once again, both conditions have arrhythmia in common. Ventricular fibrillation, or VFib, is completely opposite in the way it presents the arrhythmia. The irregularity of VFib occurs in the ventricles, while the irregularity of AFib occurs in the atria. Ventricular fibrillation, however, is more severe than atrial fibrillation. VFib is presents an immediate threat to a patient’s life, while AFib is a gradual threat to one’s life. This is because the erratic heartbeats don’t allow enough blood to be pumped to the arteries.

Atrial Fibrillation Diagnosis

When patients tell their doctor that they’re experiencing irregular heartbeats, it’s a good indication that some type of fibrillation is happening. However, in order to diagnose the exact type will need to be done by physical examination and tests. Some of the tests doctors may order include:

• EKG: This is a test that allows doctors to see the heart’s activity. This should allow doctors to see a pattern that indicates AFib. However, in order to diagnose AFib, the arrhythmia has to happen at the time of the EKG. If it doesn’t, the doctor may ask the patient to wear a Holter monitor to see if it can detect the arrhythmia.
• Holter Monitor: A Holter, or event, monitor is a portable machine that records the heart’s activity on the go. Doctors may ask their patients to where it for a full 24-hours or more to try and detect the irregularity. If this still doesn’t work, as it may not with paroxysmal atrial fibrillation, doctors may try to simulate an episode by having the patient undergo a stress test.
• Stress Test: This test requires the patient to exercise in order to elevate the heart rate and force it to work hard. Since stress can sometimes trigger AFib, this could be a quick way for doctors to diagnose this condition.

Other tests doctors may perform to further diagnose this condition are echocardiograms, chest x-rays, or blood tests. These tests may help diagnose the exact type of AFib the patient may have and the severity of the condition.

Atrial Fibrillation Causes

The connection between the upper and lower heart chambers sometimes overloads with electrical signals and creates abnormal rhythms. The many possible causes of atrial fibrillation include:

• Abnormal heart valves
• High blood pressure
• Congenital heart defects
• Overactive thyroid
• Heart attack
• Viral infections
• Stress from surgery or illness
• Lung diseases
• Sleep apnea
• Exposure to tobacco, caffeine, alcohol or stimulant medications

The cause of atrial fibrillation may differ depending on the type if AFib the patient presents. For example, paroxysmal atrial fibrillation could be caused my lifestyle habits or stress, while valvular AFib is caused by a problem with a heart valve.

Atrial Fibrillation Treatment

Treatment for atrial fibrillation is going to depend on the type a patient was diagnosed with. The most important course of treatment for this condition is to stabilize the heart rate and decrease the probability of a stroke or heart attack from occurring. These objectives can typically be accomplished with the assistance of medication, but medical procedures may be necessary if medication is not successful. Some of these medical procedures may include:

• Ablation: In this procedure, the patient will be sedated while a surgeon guides a flexible, thin tube to the area of the heart that’s causing the irregularity to occur. Once the tube has reached the trouble spot, the surgeon will either burn or freeze the tissue in that area to help prevent the arrhythmia from happening again. While there are chances that this procedure can successfully fix AFib, it may take some patients multiple ablations before it’s can be ruled a success.
• Electrical Cardioversion: This procedure attempts to reset the heart’s regular rhythm by sending an electrical shock to the heart through patches that are attached to the patient’s chest. The patient is sedated while this procedure is taking place. Once the rhythm is stabilized, doctors can continue treating the AFib with long-term medication. This procedure is not meant to be a permanent fix.
• Pacemakers: A permanent pacemaker may need to be surgically placed to consistently send electrical signals to the heart to regulate its rate.

Atrial Fibrillation Natural Treatment

While most cases of AFib will need to be treated by some sort of medical intervention, the type of AFib that’s caused by lifestyle habits can be treated naturally by changing those habits. This may include exercising, quitting smoking, eating healthy foods, destressing, and drinking little to no alcohol or caffeine. If natural treatment doesn’t stop the arrhythmia, further treatment will be necessary.

Does Atrial Fibrillation Qualify Me for Social Security?

It’s possible. Atrial fibrillation is classified with other arrhythmias, and there are several conditions to meet before receiving approval for disability payments. Know that fibrillation controlled by medication or other treatment will not qualify you.

If medication does not relieve the condition, the SSA will first review your current work status and your earnings. If your income exceeds certain limits, you will not qualify for disability. Next, your condition must be expected to last 12 months or more, and it must have a significant effect on your capacity to work. If this is the case, the SSA may classify your condition as severe. Under a severe classification, the SSA will automatically approve your case if you meet all of the qualifying conditions on Listing 4.05. These include:

• Episodes that occur even while following a doctor’s treatment.
• An arrhythmia that causes fainting or near fainting at least three separate times in 12 successive months.
• An EKG that proves the condition is related to fainting or near fainting.
• An arrhythmia that is not caused by a reversible medical condition.

To prove that you meet these conditions, you’ll need to provide detailed medical records for 12 successive months, showing exams, lab results, EKG tests, treatment and response records, the names of places you were treated and all the procedures you’ve had.

If you don’t meet the conditions for automatic approval under Listing 4.05, a doctor can still verify that atrial fibrillation interferes significantly with your work by completing a Residual Functioning Capacity form. Frequent dizziness, chest pain, weakness or shortness of breath may also qualify, and the same may be true for an inability to crawl, climb or stoop due to your arrhythmia. Chronic mental illness, including anxiety or depression, and multiple physical medical conditions may also contribute. Proof of all medical treatments is still required.

If you don’t qualify for automatic approval, the SSA will carefully review all the records and forms you submit. Clear and complete documentation of your treatment and responses will help the SSA to determine your eligibility for Social Security payments. Qualified legal representation is available to help you through this sometimes complex and lengthy process.

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