Atrial Fibrillation
Atrial fibrillation, commonly called AF or AFib, is an abnormal heart rhythm in which the upper chambers of the heart beat irregularly and often rapidly. It is one of the most common sustained heart rhythm disorders and can increase the risk of blood clots and stroke.
At DHEE Hospitals Cardiology, atrial fibrillation is evaluated based on the heart rhythm, symptoms, underlying heart condition, and individual risk factors. Treatment may focus on controlling the heart rate, restoring or maintaining a normal rhythm, and reducing the risk of stroke.
What Is Atrial Fibrillation?
The heart normally beats in a coordinated rhythm controlled by electrical signals. In atrial fibrillation, the electrical activity in the atria becomes disorganised, causing the upper chambers to quiver rather than contract normally.
This can result in an irregular heartbeat and may reduce the efficiency of blood flow through the heart.
Symptoms of Atrial Fibrillation
Some people with atrial fibrillation have no symptoms and may discover the condition during a routine examination. When symptoms occur, they may include:
- Irregular or rapid heartbeat
- Heart palpitations
- Shortness of breath
- Fatigue or weakness
- Dizziness or light-headedness
- Reduced ability to exercise
- Chest discomfort
What Causes Atrial Fibrillation?
Atrial fibrillation can occur because of changes in the heart’s electrical system or because of an underlying cardiovascular or medical condition. Possible causes and risk factors include:
- High blood pressure
- Coronary artery disease
- Heart valve disease
- Heart failure
- Cardiomyopathy
- Thyroid disorders
- Diabetes
- Obesity
- Sleep apnoea
- Excessive alcohol consumption
- Increasing age
Types of Atrial Fibrillation
Atrial fibrillation can occur in different patterns:
- Paroxysmal atrial fibrillation: Episodes begin suddenly and stop on their own, usually within seven days.
- Persistent atrial fibrillation: The abnormal rhythm continues for more than seven days and generally requires treatment to restore normal rhythm.
- Long-standing persistent atrial fibrillation: The abnormal rhythm has continued for an extended period and may require a more specialised treatment approach.
- Permanent atrial fibrillation: The patient and medical team have decided not to pursue attempts to restore normal rhythm.
Why Can Atrial Fibrillation Be Serious?
During atrial fibrillation, blood may not move normally through the atria. This can allow a blood clot to form. If a clot travels to the brain, it can cause a stroke.
Atrial fibrillation can also contribute to worsening heart failure or other cardiovascular complications in some patients, particularly when the heart rate remains uncontrolled.
How Is Atrial Fibrillation Diagnosed?
Electrocardiogram
An ECG is one of the main tests used to identify atrial fibrillation. It records the heart’s electrical activity and can show the characteristic irregular rhythm.
Holter and Extended Rhythm Monitoring
If atrial fibrillation occurs intermittently, a Holter monitor or longer-term rhythm monitor may be used to detect episodes that are not present during a routine ECG.
Echocardiogram
An echocardiogram evaluates the structure and function of the heart and can identify conditions such as valve disease or reduced heart function that may be associated with atrial fibrillation.
Blood Tests
Blood tests may be performed to evaluate thyroid function, electrolytes, blood count, kidney function, and other factors that can contribute to or influence treatment of atrial fibrillation.
Treatment for Atrial Fibrillation
Treatment is individualised according to symptoms, duration and type of atrial fibrillation, heart function, other medical conditions, and the patient’s risk of stroke.
Medicines to Control Heart Rate
Medicines may be prescribed to slow the heart rate and help control symptoms when the heart is beating too rapidly.
Medicines to Restore or Maintain Heart Rhythm
In selected patients, antiarrhythmic medicines may be used to help restore or maintain a normal heart rhythm.
Medicines to Reduce Stroke Risk
Some patients with atrial fibrillation require anticoagulant medicines to reduce the risk of blood clots and stroke. The decision is based on an individual’s stroke risk and bleeding risk.
Electrical Cardioversion
Electrical cardioversion uses a controlled electrical shock to restore a normal heart rhythm. It may be considered for selected patients with atrial fibrillation.
Catheter Ablation
Catheter ablation is a minimally invasive procedure that targets areas responsible for abnormal electrical signals. It may be recommended for selected patients, particularly when symptoms continue despite medication or when ablation is otherwise appropriate.
Atrial Fibrillation and Stroke Prevention
Stroke prevention is an important part of atrial fibrillation management. Not everyone with atrial fibrillation requires anticoagulation. Cardiologists assess individual risk factors before deciding whether blood-thinning medication is appropriate.
Patients taking anticoagulants should use them exactly as prescribed and should not stop treatment without discussing it with their doctor.
Lifestyle Management
Lifestyle changes can support the management of atrial fibrillation and cardiovascular health.
- Control high blood pressure.
- Manage diabetes and cholesterol.
- Maintain a healthy body weight.
- Avoid smoking.
- Limit excessive alcohol consumption.
- Stay physically active as recommended by your doctor.
- Address sleep apnoea when present.
- Attend regular medical and cardiology follow-up appointments.
When Should You Seek Emergency Care?
Seek emergency medical attention if you experience a rapid or irregular heartbeat accompanied by severe chest pain, significant breathing difficulty, fainting, severe dizziness, or sudden weakness.
Sudden facial drooping, weakness or numbness on one side of the body, difficulty speaking, confusion, or sudden vision problems may indicate a stroke and require immediate emergency treatment.
Atrial Fibrillation Care at DHEE Hospitals Cardiology
DHEE Hospitals Cardiology provides evaluation and management for patients with atrial fibrillation and other heart rhythm disorders. Assessment may include ECG, ambulatory rhythm monitoring, echocardiography, blood tests, and other investigations based on the patient’s symptoms and medical history.
Treatment is planned according to the patient’s heart rhythm, symptoms, stroke risk, underlying cardiovascular conditions, and overall health. Ongoing follow-up may be recommended to monitor the rhythm and adjust treatment when required.
Frequently Asked Questions About Atrial Fibrillation
Is atrial fibrillation dangerous?
Atrial fibrillation can increase the risk of blood clots and stroke and may contribute to other cardiovascular complications. The level of risk varies between individuals and depends on factors such as age, medical conditions, and heart health.
Can atrial fibrillation go away on its own?
Some episodes of paroxysmal atrial fibrillation stop on their own. However, recurring episodes still require medical evaluation because atrial fibrillation can have important long-term risks.
Can atrial fibrillation be cured?
Treatment can sometimes restore and maintain a normal heart rhythm, but atrial fibrillation may recur. Medicines, cardioversion, catheter ablation, and management of underlying conditions may be used depending on the individual situation.
Do all people with atrial fibrillation need blood thinners?
No. The need for anticoagulant treatment depends on the individual’s risk of stroke and bleeding and other clinical factors. A cardiologist can determine whether anticoagulation is appropriate.
Can atrial fibrillation cause fatigue?
Yes. An irregular or rapid heart rhythm can reduce exercise tolerance and may cause fatigue, weakness, or shortness of breath.
