Atrial Fibrillation and Atrial Flutter in Cats
There are four chambers in the heart. The two top chambers are called the atria (single: atrium) whereas the bottom chambers are called the ventricles. Valves are provided between each atrial and ventricular pair, each on the left and right side. The valve between the right atrium and right ventricle is called the tricuspid valve, where the valve between the left atrium and left ventricle is called the mitral valve. The heart works with exceptional synchronization between the various atrial and ventricular structures, resulting in a consistent rhythmic pattern.
In both atrial fibrillation and atrial flutter this rhythm is disturbed and synchronization is lost between the atria and ventricles. Both conditions refer to a rhythm problem that originates in the upper chambers of the heart, that is, the atria. Atrial flutter is often a precursor to atrial fibrillation. In atrial flutter there is a premature electrical impulse that arises in the atria, resulting in a faster than normal heart rate, either regular or irregular in frequency, whereas in atrial fibrillation there is quivering type of contraction of the heart muscles, resulting in a rapid and abnormally paced heart rhythm, also referred to as arrhythmia. In atrial fibrillation the atria beat chaotically, resulting in irregular rhythms of the ventricle as well. On an electrocardiogram (ECG), which measures the electrical activity of the heart, a distinct pattern can be differentiated in atrial fibrillation and atrial flutter. Older male cats have been found to be more susceptible to this condition.
Symptoms and Types
Atrial fibrillation is categorized by relevance, including:
- Primary atrial fibrillation
- No underlying cardiac disease involved – cause not identified
- Secondary atrial fibrillation
- Severe underlying cardiac disease like CHF is usually involved
- Paroxysmal atrial fibrillation
- Periodic, recurrent episodes, which last for a short period of time (less than seven days), with the heart returning to its normal rhythm on its own
- Persistent atrial fibrillation
- Arrhythmia lasts for more than 48 hours, only responds to treatment
- Permanent atrial fibrillation
- Ongoing arrhythmia, cannot be treated
The symptoms generally relate to an underlying disease like congestive heart failure (CHF). Following are few of the symptoms related to atrial fibrillation.
- Galloping heart
- Exercise intolerance
- Dyspnea (Difficult breathing)
- Tachypnea (Rapid respiratory rate)
- Syncope/Loss of consciousness (rare)
- Chronic disease of the heart involving the valves
- Enlargement of the heart
- Cardiomyopathy (heart muscle disease)
- Congenital heart disease
- Digoxin (drug commonly used to treat various heart diseases) toxicity
- As a sequel congestive heart failure (CHF)
- Cause may remain unknown
After taking a detailed history of your cat’s health, onset of symptoms, and possible incidents that might have preceded this condition, your veterinarian will perform a complete physical examination. Laboratory tests will include complete blood tests, a biochemical profile, and urinalysis. It is possible that the results of these tests may not reveal much information related to this disease, but they may be helpful for accessing an overall picture of your cat’s health and reveal other diseases, if present. Additional diagnostic tools include echocardiography (ECG), X-ray imaging, and color Doppler to help in characterizing the type and severity of any underlying heart disease.
Your veterinarian will first diagnose the level of flutter or fibrillation your cat is experiencing, and whether there is an underlying disease of the heart, such as CHF, that is responsible for the atrial arrhythmia. If the heart is beating too rapidly, your cat will be treated medically for the rhythm to be slowed down. If no underlying disease is found to be present, the treatment will be directed towards normalizing the rhythm of heart and getting the sinoatrial node back into sync with the atrioventricular node (AV) node. If the fibrillation is a chronic problem (more than four months), the success rate drops accordingly. Electrical shock therapy may be used to normalize the rhythm is some cases. If an underlying cardiac disease like CHF is present, the treatment will also be directed towards its treatment, along with stabilizing the heart rhythm.
Living and Management
Follow your veterinarian’s guidelines regarding diet, exercise, rest, medication, and management of your cat at home. In cases of primary atrial fibrillation, recurrence can occur, especially in patients with chronic problems. Observe your cat’s health and call your veterinarian if you notice any symptoms that appear abnormal. In cases of severe cardiac diseases like CHF, a high level of commitment and care will be required on your part for the treatment and management of your cat’s home care. Keeping a diary of all events and staying in touch with your veterinarian throughout treatment period will help you to follow your cat’s progress.