Restoring normal sinus rhythm: What is it?

What is a Normal Sinus Rhythm?

In addition to managing your stroke risks, you and your provider may consider strategies to help you achieve what is called “normal sinus rhythm.”

What is the definition of “cured” for atrial fibrillation?

A regular pumping rhythm is an important goal, and many people who are able to achieve long-term stability with their sinus rhythm feel that their AFib is “cured.” The possibility of a lasting “cure” is most likely for people who have episodes of AFib that come and go (called paroxysmal AFib). This group is likely to have fewer complications and may experience rapid treatment success.

What is a normal sinus rhythm? Understanding Your Heart’s Electrical System

The Heartbeat Starting Point: Your SA Node The heart beats (or contracts) when an electrical impulse from the sinoatrial node (also called the SA node or sinus node) moves through the tissue of the heart. The SA node is sometimes referred to as the heart's "natural pacemaker" because it initiates impulses for the heartbeat.

The Orderly Signals For Normal Heartbeats: The normal electrical sequence begins in the right atrium and spreads throughout the atria to the atrioventricular (AV) node. From the AV node, electrical impulses travel down a group of specialized fibers called the His-Purkinje system to all parts of the ventricles.

This exact route must be followed for the heart to pump properly. As long as the electrical impulse is transmitted normally, the heart pumps and beats at a regular pace. In an adult, a normal heart beats 60 to 100 times a minute. When everything works correctly, your heart is said to be in “normal sinus rhythm.”

Atrial Fibrillation and Erratic Heartbeats: During atrial fibrillation, the sinus rhythm is disrupted and contraction signals may fire erratically from various places in the heart tissue or the nearby veins, often causing uncoordinated, fast or irregular contractions throughout the tissue and muscle around the heart. This uncoordinated timing creates a risk for blood clots to develop that can lead to stroke, so achieving a normal sinus rhythm and adhering to any clot-prevention strategies your healthcare provider advises for you are important goals.

Many people with AFib consider their condition to be cured when they achieve normal sinus rhythm and are able to maintain for a period of years. However, follow up treatment will continue to be important. A significant portion of those with AFib are unaware of any symptoms, so it is not a good idea to disregard recommended follow-up visits simply because you do not notice anything wrong.

Learn more about the normal heartbeat and atrial fibrillation.

Recent Discussions From The Providers Office Forum
mikeqi2011 avatar

Hi everyone! I joined the group and introduced myself in June after being diagnosed with persistent afib, mostly asymptomatic. My cardiologist and a very young EP at UCLA basically recommend that I just live with it. I'm an otherwise healthy 70 year old, work out 3-5 times a week and lead an active lifestyle. I'm on Eliquis and Metoprolol (12.5 twice a day). My heart is otherwise healthy. I was diagnosed in March but have probably been in afib for 12 - 18 months (don't know for sure).


My concern is about the long term toll of persistent afib and am exploring other doctors/opinions. Given that I have persistent afib, I have reached out to Dr. Randall Wolf in Houston regarding the mini-maze and am trying to identify equally reputable providers in Southern California (for mini-maze or ablation). I would very much appreciate recommendations of providers as well as thoughts in general.


My cardiologist told me that, if I were his brother, he would tell me the same, i.e., stop worrying, take the meds to control the risks, monitor and enjoy life. I hear him, but I'm not ready to accept this without additional consultations. BTW, I don't feel that the afib is truely asymptomatic. It's not the same as NSR, you know you're in it from this strange feeling of unease, and you tire a bit more easily....


Thanks in advance for your thoughts! And thanks to Melanie and everyone who makes this forum possible....


Mike

Wayne avatar

I am a 78-year old male with persistent AFIB for about the last 20 years with only occasional instances of racing heart rate.  In 2010, I had open heart surgery to replace the aortic valve along with a triple by-pass and a cryo-maze procedure to correct the AFIB (the maze procedure only fixed the AFIB for about a month).  In my opinion, I have been doing very well and see my personal physician and cardiologist twice a year.  I keep a good record of my vitals on a weekly basis.  Every so often (2 to 3 times a year) I note that my heart rate (normally 68-70 BPM) while sleeping will dive to the 40's and 50's and stay at that lower rate for a week or two.  Neither of my doctors seem concerned about this.  During my discussion last week with my cardiologist, while discussing this issue, he stated that AFIB can result in low heart rates as well as high heart rates and talked about a pacemaker if and when the low heart rate situation warrants it.  I did not know that AFIB could cause low heart rates and would like to hear if others on this forum have expeienced low heart rates as a result of AFIB.  Thanks.

Trish avatar

Still sifting through the reams of info on ablation. Seems no real consensus on anything except that the centers that do the most have the best outcomes. Saw my lovely, warm dr yesterday for consult on ablation...when or if to do. He is outstanding and I was ready to pull the trigger on the procedure when he told me that since he is at a teaching hospital, his students(fellows) do the ablation with his oversight and correction when needed. I should have realized this but did not. So...the centers that do lots of ablations without student participation narrows the field considerably and let's out some of the major players. Please share any experiences. I am ready and will to travel but would prefer Miami/NYC area. Also, anyone out there have ablation at a teaching hospital?

Trish

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