Overview of 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 put you at risk of blood clots and stroke. 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 maybe 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.
Types of atrial fibrillation
There are three types of atrial fibrillation:
Paroxysmal AF: This is a type of AF that comes and goes. The episodes last for minutes, hours, or days, but usually no more than a week.
Continuous AF: AF episodes last for more than seven days in a row.
Persistent or permanent chronic AF: Your AF lasts for more than a year.
Atrial fibrillation is a progressive disease, so it is not uncommon for people with paroxysmal AF to develop persistent or permanent AF over time.
Symptoms of atrial fibrillation
Some people with atrial fibrillation have no symptoms and are unaware of their condition until it is found during a physical exam. People with atrial fibrillation may experience signs and symptoms:
- Heart palpitations
- Chest pain
- Shortness of breath
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.
What causes atrial fibrillation?
Atrial fibrillation is an irregular and often rapid heartbeat that occurs when the two upper chambers of the heart experience chaotic electrical signals. The result is a fast and irregular heartbeat. The heart rate in atrial fibrillation can range from 100 to 175 beats per minute. The normal range of heart rate is 60 to 100 beats per minute.
Your heart is made up of four chambers: two upper chambers (atria) and two lower chambers (ventricles). In the upper right chamber of your heart (right atrium) there is a group of cells called the sinus node. It is the natural pacemaker of your heart. The sinus node generally produces a signal that activates each heartbeat.
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
- Heart surgery
- Congenital heart defects
- An overactive thyroid gland
- Taking certain medications
- Binge drinking
- Thyroid disease
Risk factors for atrial fibrillation
While the exact cause of AFib isn’t always known, some factors 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:
- 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
- History of heart attacks
- History of heart surgery
- Metabolic syndrome
- Lung disease
- Drinking alcohol
- Sleep apnea
- High-dose steroid therapy
Diagnosis of atrial fibrillation
A variety of tests can be done to get a better idea of what is happening to your heart function.
Your doctor may use one or more of the following tests to diagnose atrial fibrillation:
- Physical exam to check your pulse, blood pressure, and lungs
- Electrocardiogram (EKG), a test that records the electrical impulses from your heart for a few seconds.
If atrial fibrillation does not occur during the EKG, your doctor may recommend that you use 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.
- Echocardiogram, a noninvasive test that uses sound waves to produce a moving image of your heart.
- A transesophageal echocardiogram, an invasive version of an echocardiogram that’s performed by placing a probe in the oesophagus.
- A 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.
The atrial fibrillation treatment that is most appropriate for you will depend on how long you’ve had atrial fibrillation, how bothersome your symptoms are and the underlying cause of your atrial fibrillation. Generally, the treatment goals for atrial fibrillation are to:
- Reset the rhythm or control the rate
- Prevent blood clots, which may decrease the risk of a stroke
The strategy you and your doctor choose depends on many factors, including whether you have other problems with your heart and if you’re able to take medications that can control your heart rhythm. In some cases, you may need a more invasive treatment, such as medical procedures using catheters or surgery.
In some people, a specific event or an underlying condition, such as a thyroid disorder, may trigger this disease. Treating the condition may help relieve your heart rhythm problems. If your symptoms are bothersome or if this is your first episode of atrial fibrillation, your doctor may attempt to reset the rhythm
This can sometimes cause the following problems:
Race. Chaotic rhythm causes blood to pool and clot in the upper chambers of your heart (atria). If a blood clot forms, it can leave your heart and travel to your brain. There it blocks blood flow, causing a stroke.
The risk of stroke in atrial fibrillation depends on your age, and if you have high blood pressure, diabetes, and a history of heart failure or previous stroke. Some medications, such as blood thinners, can increase your risk of stroke or damage other organs caused by blood clots.
Heart failure. Especially if left unchecked, can weaken the heart and lead to heart failure, a condition in which your body does not circulate enough blood to meet your body’s needs.
Most cases of atrial fibrillation can be managed or treated. But this tends to reoccur and get worse over time.
You can reduce your risk 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
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.