Atrial fibrillation

Atrial fibrillation is the most common type of heart arrhythmia (irregular heartbeat) that can interrupt the normal flow of blood. This interruption means the conditions puts you at risk of blood clots and stroke.

Between 2.7 and 6.1 million U.S. people have atrial fibrillation (AFib or AF).

With AFib, the two upper chambers of your heart (atria) are affected. This disrupts blood flow to the ventricles or the lower chambers, and then throughout the rest of your body.

If left untreated, AFib can be deadly.

Atrial fibrillation may be temporary, may come and go, or may be permanent. It’s also most common in adults over the age of 65. But with proper medical care, you can live a normal, active life.

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The heart contains four chambers: two atria and two ventricles.

Atrial fibrillation happens when these chambers don’t work together as they should because of faulty electrical signaling.

Normally, the atria and ventricles contract at the same speed. In atrial fibrillation, the atria and ventricles are out of sync because the atria contract very quickly and irregularly.

The cause of atrial fibrillation isn’t always known. Conditions that can cause damage to the heart and lead to atrial fibrillation include:

  • high blood pressure
  • congestive heart failure
  • coronary artery disease
  • heart valve disease
  • hypertrophic cardiomyopathy, in which the heart muscle becomes thick
  • heart surgery
  • congenital heart defects, meaning heart defects you’re born with
  • an overactive thyroid gland
  • pericarditis, which is inflammation of the sac-like covering of the heart
  • taking certain medications
  • binge drinking
  • thyroid disease

An overall healthy lifestyle may decrease your risk of AFib. But not all causes are preventable.

It’s important to tell your doctor about your full health history so they can better pinpoint the causes of your AFib and are better able to treat it.

While the exact cause of AFib isn’t always known, there are some factors that may put you at a higher risk for this condition. Some of these may be prevented, while others are genetic.

Talk to your doctor about the following risk factors:

  • increased age (the older you are, the higher your risk)
  • being white
  • being male
  • a family history of atrial fibrillation
  • heart disease
  • structural heart defects
  • congenital heart defects
  • pericarditis
  • history of heart attacks
  • history of heart surgery
  • thyroid conditions
  • metabolic syndrome
  • obesity
  • lung disease
  • diabetes
  • drinking alcohol, especially binge drinking
  • sleep apnea
  • high-dose steroid therapy

You might not experience any symptoms if you have atrial fibrillation.

Those who do experience symptoms may notice:

  • heart palpitations (feeling like your heart is skipping a beat, beating too fast or hard, or fluttering)
  • chest pain
  • fatigue
  • shortness of breath
  • weakness
  • lightheadedness
  • dizziness
  • fainting
  • confusion
  • intolerance to exercise

These symptoms can come and go based on the severity of your condition.

For example, paroxysmal AFib is a type of atrial fibrillation that resolves on its own without medical intervention. But you may need to take medication to prevent future episodes and potential complications.

Overall, you might experience symptoms of AFib for several minutes or hours at a time. Symptoms that continue over several days could indicate chronic AFib.

There are several different tests that can be done to get a better idea of what’s going on with your heart function.

Your doctor may use one or more of the following tests to diagnose atrial fibrillation:

  • a physical exam to check your pulse, blood pressure, and lungs
  • an electrocardiogram (EKG), a test that records the electrical impulses of your heart for a few seconds

If atrial fibrillation doesn’t occur during the EKG, your doctor may have you wear a portable EKG monitor or try another type of test.

These tests include:

  • Holter monitor, a small portable device you wear for 24 to 48 hours to monitor your heart.
  • event monitor, a device that records your heart only at certain times or when you’re having symptoms of AFib
  • echocardiogram, a noninvasive test that uses sound waves to produce a moving image of your heart.
  • transesophageal echocardiogram, an invasive version of an echocardiogram that’s performed by placing a probe in the esophagus
  • stress test, which monitors your heart during exercise
  • chest X-ray to view your heart and lungs
  • blood tests to check for thyroid and metabolic conditions

For chronic or severe AFib, surgery may be a recommended option.

There are different types of surgeries that target the heart muscle in an effort to help it pump blood more efficiently. Surgery may also help prevent heart damage.

Types of surgeries that may be used to treat AFib include:

Electrical cardioversion

In this procedure, a brief electrical shock resets the rhythm of your heart contractions.

Catheter ablation

In catheter ablation, a catheter delivers radio waves to the heart to destroy the abnormal tissue that sends out irregular impulses.

Atrioventricular (AV) node ablation

Radio waves destroy the AV node, which connects the atria and ventricles in this procedure. Then the atria can no longer send signals to the ventricles.

A pacemaker is inserted to maintain a regular rhythm.

Maze surgery

This is an invasive surgery that can be either open-heart or through small incisions in the chest, during which the surgeon makes small cuts or burns in the heart’s atria to create a “maze” of scars that will prevent abnormal electrical impulses from reaching other areas of the heart.

This surgery is only used in cases when other treatments were unsuccessful.

Your doctor might also recommend other procedures to treat underlying health conditions, such as thyroid or heart diseases, which might be causing your AFib.

Surgery is one treatment method for AFib. Still, medications and lifestyle changes are recommended as first lines of treatment. Your doctor may recommend surgery as a last resort if your condition is severe.

Most cases of atrial fibrillation can be managed or treated. But atrial fibrillation tends to reoccur and get worse over time.

You can reduce your risk of atrial fibrillation by doing the following:

  • eat a diet that’s rich in fresh fruits and vegetables and low in saturated and trans fat
  • exercise regularly
  • maintain a healthy weight
  • avoid smoking
  • avoid drinking alcohol or only drink small amounts of alcohol occasionally
  • follow your doctor’s advice for treating any underlying health conditions that you have

The most common complications of AFib are strokes and heart failure.

If you have AFib and aren’t taking proper medication, you are five times more likely to have a stroke than people who don’t have AFib.

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